Methods and compositions for locally increasing body fat

ABSTRACT

Provided are methods for increasing fat locally in a body of a subject in need thereof comprising percutaneously administering to the subcutaneous fat of the subject a thiazolidinedione or an orexigenic compound, or a pharmaceutically acceptable salt or prodrug thereof, optionally delivered as a composition comprising a pharmaceutically acceptable carrier, as described herein. In certain embodiments, the pharmaceutically acceptable carrier comprises a percutaneous carrier, as described herein. Further provided are compositions comprising a thiazolidinedione or an orexigenic compound, or a pharmaceutically acceptable salt or prodrug thereof, for use according to the invention.

RELATED APPLICATIONS

The present application claims priority under 35 U.S.C. §119(e) to U.S.provisional patent application, U.S. Ser. No. 61/729,051, filed Nov. 21,2012, which is incorporated herein by reference.

FIELD OF THE INVENTION

The present invention relates to methods and compositions for increasingfat and/or adipocytes locally in the body of a subject. Morespecifically, body fat may be increased locally by percutaneouslyadministering to the skin of a subject a compound that is athiazolidinedione or an orexigenic pregnane derivative, optionallydelivered as a composition comprising a pharmaceutically acceptablecarrier, as described herein. In certain embodiments, thepharmaceutically acceptable carrier comprises a percutaneous carrier, asdescribed herein.

BACKGROUND OF THE INVENTION

A number of medical and cosmetic conditions involve deficiencies of bodyfat. A body fat deficiency can be diffuse or concentrated on particularpart(s) of the body, e.g., the head, face (e.g., cheeks, chin, jaw,lips), limbs (e.g., arms, hands, thighs, legs), and/or torso (e.g.,chest, breast, abdomen, buttocks). A body fat deficiency can be due, forexample, to loss of body fat (e.g., atrophy, lipoatrophy, wasting,degeneration, fibrosis, fat removal, trauma), failure of body fat todevelop (e.g., aplasia, hypoplasia), and/or movement of fat away from abody part of interest (e.g., migration, descent, involution). Somecauses of body fat deficiency include disease, metabolic state,medications, medical procedures, and trauma. Furthermore, a number ofmedical and cosmetic conditions can benefit from an increase in body fateven where a body fat deficiency does not exist. For example, skinwrinkles or loose skin can be ameliorated and/or treated by an increaseof body fat underneath or near the skin wrinkles. Individualsdissatisfied with the appearance, size, or contour of body part(s),e.g., breast, buttocks, lips, face, and/or cheeks, can benefit from anincrease in body fat in or near the body part(s).

A number of surgical methods have been developed to ameliorate and/ortreat the above conditions. For example, adipose or other tissue can beextracted or liberated from one part of the body and redeposited inanother (e.g., autologous fat transplantation). Likewise, tissue can betransplanted from a live human, cadaveric, or nonhuman donor.Space-occupying synthetic materials (e.g., silicone, saline, Restylane®,Juvederm®, Perlane®) can be deposited into or near a body part ofinterest. Generally, the above methods are invasive and can cause pain,scars, fibrosis, infection, inflammation, foreign body reaction,post-procedural deformity or regression, implant migration, and otheradverse reactions.

Therefore, there is a need for new pharmaceutical compositions andmethods for locally increasing fat in a body of a subject.

SUMMARY OF THE INVENTION

Given the disadvantages of surgery and injections, there has been a longfelt need for a medicine that can be applied to the skin, penetrate theskin, and locally increase adipose tissue. U.S. Pat. No. 8,367,606suggests, based on in vitro results, that an agonist of PeroxisomeProliferator-Activated Receptor Gamma (PPARγ), e.g., athiazolidinedione, could be applied topically to the skin of anindividual to increase body fat locally. However, this and otherreferences lack working examples. In fact, in actual studies where suchcompounds have been administered to skin, no local increases in fat werenoted. See, e.g., Kuenzli and Saurat, Dermatology (2003) 206:252-256.

Furthermore, the prior art fails to address or even recognize a keypractical problem: how to deliver an effective amount ofthiazolidinedione to subcutaneous fat without a systemic effect. This iscrucial, because thiazolidinediones can have systemic toxicities such asobesity, cardiovascular disease, and increased incidence of certaincancers. Thus, systemic absorption must be minimized or avoided. Suchdelivery is technically challenging due to the “sink effect” of thedermal circulation, whereby drugs that penetrate the skin are rapidlyabsorbed into the systemic circulation by a dense network of dermalcapillaries. For example, when the thiazolidinedione rosiglitazone isapplied to the skin in a patch form, substantial amounts of the drugappear in the bloodstream, leading to systemic effects. See, e.g.,Damodharan et al, Skin permeation of rosiglitazone from transdermalmatrix patches, Pharmaceutical Technology (2010) 34:56-72. See also,e.g., Ghosh et al, Feasibility of rosiglitazone maleate for transdermaldelivery, Int. J. Pharm. Res. Innov. (2011) 2:23-31.

The distinctions between superficial skin administration, systemic(transdermal) delivery to the bloodstream, and percutaneous deliveryinto fat are illustrated in FIG. 1. See, e.g., Dayan N, Delivery SystemDesign in Topically Applied Formulations: An Overview, in Rosen M,Delivery System Handbook for Personal Care and Cosmetic Products,William Andrew, 2005, pp. 103-104; Kao J, In Vitro Assessment of DermalAbsorption, in Hobson D W, Dermal and Ocular Toxicology: Fundamentalsand Methods, CRC Press, 1991, pp. 272-273. Delivering a drug across theskin and into the systemic circulation (e.g., transdermally, into thebloodstream) is a common practice. An example of such delivery is anicotine patch, which results in delivery of nicotine across the skininto the bloodstream. Compared to transdermal administration, there aregreat technical challenges to delivering a drug across the skin and intosubcutaneous fat while avoiding systemic exposure. See, e.g., Dayan etal, supra; Kao, supra. The reason for this is the “sink condition” ofthe dermal circulation. Because the dermis is invested by a network ofcapillaries with rapid blood flow, for any drug that penetrates thedermis, a wide concentration gradient is created between the skin andbloodstream. Thus, there is a strong tendency for drugs that penetrateinto the dermis to diffuse rapidly down this gradient into thebloodstream. This sink phenomenon favors systemic delivery (e.g., to thebloodstream, as with a nicotine patch), but undermines attempts at localdelivery (e.g., to subcutaneous fat, as in the present invention). Nomethod of reasoning or prediction is available in the art to suggestwhich formulations, if any, can circumvent the sink condition.

The present invention arises from a discovery that percutaneouslyadministering a thiazolidinedione or an orexigenic compound to asubject, i.e., such that a therapeutic effect is achieved in localsubcutaneous fat without a systemic effect, effectively achieves a localincrease in subcutaneous fat, e.g., without deleterious side effects.

Thus, in one aspect, provided is a method for increasing fat locally ina body of a subject in need thereof, the method comprisingpercutaneously delivering to the subcutaneous fat of the subject athiazolidinedione or an orexigenic compound, or a pharmaceuticallyacceptable salt or prodrug thereof. In certain embodiments, thedelivering (administering) step comprises topical application to theskin, or by intradermal injection, subcutaneous injection, intramuscularinjection, intralesional injection, transmucosal injection, or mucosalapplication.

In certain embodiments, the increasing fat locally in a body of asubject results in an increase in subcutaneous fat thickness at thetreated site on a subject (e.g., at least a 10%, at least a 20%, atleast a 30%, or at least a 40% increase in subcutaneous fat thickness)compared to a control site on the subject, or compared to the baseline(pre-administration) subcutaneous fat measurement.

In certain embodiments, the subject suffers from a subcutaneous fatdeficiency.

In certain embodiments, the subcutaneous fat deficiency is associatedwith a metabolic disorder. In certain embodiments, the metabolicdisorder is insulin resistance, diabetes, lipase deficiency, wasting,malnutrition, paraneoplastic condition, anorexia, pernicious anemia,celiac disease, or malabsorption syndrome.

In certain embodiments, the subcutaneous fat deficiency is associatedwith an inflammatory condition. In certain embodiments, the inflammatorycondition is complement component 3 (C3) deficiency,membranoproliferative glomerulonephritis, systemic lupus erythematosus,dermatomyositis, rheumatoid arthritis, temporal arteritis, orleukocytoclastic vasculitis.

In certain embodiments, the subcutaneous fat deficiency is acquired. Incertain embodiments, the acquired subcutaneous fat deficiency isHIV-associated lipodystrophy, lipidema, acquired partial lipodystrophy,acquired generalized lipodystrophy, Parry-Romberg syndrome, juveniledermatomyositis, centrifugal abdominal lipodystrophy, lipoatrophiaannularis, or localized lipodystrophy.

In certain embodiments, the subcutaneous fat deficiency is congenital.

In certain embodiments, the congenital subcutaneous fat deficiency iscongenital generalized lipodystrophy, familial partial dystrophy,Nakajo-Nishimura syndrome, Cockayne syndrome, SHORT syndrome, AREDYLDsyndrome, mandibuloacral dysplasia, Keppen-Lubinsky syndrome, POEMSsyndrome, Werner syndrome, Hutchinson-Gilford syndrome, or progeria.

In certain embodiments, the subcutaneous fat deficiency is caused by alipoatrophy-causing mutation in a gene selected from the groupconsisting of APLD, AKT2, C3, CAV1, CGL1 (AGPAT2), and CGL2 (BSCL2),LMF1, LMNA, PLIN1, PPARG, PSMB8, PTRF, and ZMPSTE24.

In certain embodiments, the subcutaneous fat deficiency is caused by amedication, surgery, or an injury.

In certain embodiments, the subject suffers from wrinkles of the skin,and the method comprises minimizing the appearance of wrinkles.

In certain embodiments, the subject suffers from dissatisfaction withthe size or contour of a body part, and the method comprises modifyingthe contour of the body part. In certain embodiments, the body part isthe face, forehead, periorbital region of the face, midface, cheeks,chin, lips, other anterior structures from top of forehead to bottom ofchin, breast, limbs, hands, trunk, hips, or buttocks.

In certain embodiments, the subject has transplanted fat, and the methodcomprises augmenting the transplanted fat.

In certain embodiments, the subject suffers from diabetes, HIV, familiallipodystrophy, or a subcutaneous fat deficiency.

In certain embodiments, the thiazolidinedione is a compound of Formula(I):

or a pharmaceutically acceptable salt or prodrug thereof;wherein:

Ring A is substituted or unsubstituted arylene or substituted orunsubstituted heteroarylene;

L is substituted or unsubstituted C₁₋₆ alkylene or substituted orunsubstituted heteroC₁₋₆alkylene; and

Ring B is substituted or unsubstituted carbocyclyl, substituted orunsubstituted heterocyclyl, substituted or unsubstituted aryl, orsubstituted or unsubstituted heteroaryl.

In certain embodiments, the thiazolidinedione is selected from the groupconsisting of:

and pharmaceutically acceptable salts and prodrugs thereof.

In certain embodiments, the orexigenic compound is a compound of Formula(II):

or a pharmaceutically acceptable salt or prodrug thereof;wherein:

each instance of

independently represents a single or double bond;

R¹ is hydrogen, hydroxyl, substituted hydroxyl, thiol, substitutedthiol, amino, or substituted amino;

R² is hydrogen, hydroxyl, substituted hydroxyl, thiol, substitutedthiol, amino, or substituted amino;

R³ is hydrogen or substituted or unsubstituted C₁₋₆alkyl;

R⁴ is hydrogen, hydroxyl, substituted hydroxyl, thiol, substitutedthiol, amino, or substituted amino, and R⁵ is hydrogen; or R⁴ and R⁵ arejoined to form an oxo group ═O.

In certain embodiments, the orexigenic compound is selected from thegroup consisting of:

and pharmaceutically acceptable salts thereof.

In certain embodiments, the method comprises percutaneously deliveringto the subcutaneous fat of the subject a composition comprising betweenabout 0.0001 percent to about 5 percent by weight, inclusive, of thethiazolidinedione or an orexigenic compound, or pharmaceuticallyacceptable salt or prodrug thereof, to the subject. In certainembodiments, the concentration of the thiazolidinedione, orpharmaceutically acceptable salt or prodrug thereof, is between about0.1 percent and about 5 percent by weight, inclusive. In certainembodiments, the concentration of the orexigenic compound, orpharmaceutically acceptable salt or prodrug thereof, is between about0.1 percent and about 5 percent by weight, inclusive.

In another aspect, provided is a composition for percutaneousadministration comprising a thiazolidinedione or an orexigenic compound,or a pharmaceutically acceptable salt or prodrug thereof, and apharmaceutically acceptable carrier. In certain embodiments, thecomposition is a pharmaceutical composition or a cosmetic composition.In certain embodiments, the composition comprises a therapeuticallyeffective amount of the thiazolidinedione or an orexigenic compound, ora pharmaceutically acceptable salt or prodrug thereof.

In certain embodiments, the pharmaceutically acceptable carriercomprises a percutaneous carrier. In certain embodiments, thecomposition comprises a percutaneous carrier. In certain embodiments,the composition comprises a carrier (optionally a percutaneous carrier)for intradermal injection, subcutaneous injection, intramuscularinjection, intralesional injection, transmucosal injection, or mucosalapplication. In certain embodiments, the percutaneous carrier is acarrier according to one of the working examples provided herein; see,e.g., Examples 1 to 11.

In certain embodiments, the percutaneous carrier comprises one or morefatty acids. In certain embodiments, the fatty acid is oleic acid. Incertain embodiments, the oleic acid is present at a concentrationbetween about 1 and about 10 percent by weight.

In certain embodiments, the percutaneous carrier comprises one or moreorganic alcohols (e.g., ethanol and/or propylene glycol). In certainembodiments, the final concentration of the organic alcohol is betweenabout 5 percent and about 99 percent by weight.

In certain embodiments, the composition comprises a thiazolidinedione oran orexigenic compound, or a pharmaceutically acceptable salt or prodrugthereof, and a percutaneous carrier comprising a fatty acid (e.g., oleicacid), wherein the fatty acid concentration is between about 1 and about10 percent by weight in the composition. In certain embodiments, thepercutaneous carrier further comprises an organic alcohol (e.g.,propylene glycol and/or ethanol). In certain embodiments, the organicalcohol concentration is between about 5 percent and about 99 percent byweight in the composition. In certain embodiments, the compositionfurther comprises a penetration enhancer. In certain embodiments, thecomposition further comprises a viscosity enhancing agent. In certainembodiments, the composition further comprises an antioxidant.

In certain embodiments, the composition is anhydrous (e.g., comprisesbetween 0% to 1% water, inclusive).

In certain embodiment, the composition is a gel.

The details of one or more embodiments of the invention are set forth inthe accompanying Figures below. Other features, objects, and advantagesof the invention will be apparent from the Detailed Description,Examples, and the Claims.

DEFINITIONS

Definitions of specific functional groups and chemical terms aredescribed in more detail below. The chemical elements are identified inaccordance with the Periodic Table of the Elements, CAS version,Handbook of Chemistry and Physics, 75^(th) Ed., inside cover, andspecific functional groups are generally defined as described therein.Additionally, general principles of organic chemistry, as well asspecific functional moieties and reactivity, are described in OrganicChemistry, Thomas Sorrell, University Science Books, Sausalito, 1999;Smith and March March's Advanced Organic Chemistry, 5^(th) Edition, JohnWiley & Sons, Inc., New York, 2001; Larock, Comprehensive OrganicTransformations, VCH Publishers, Inc., New York, 1989; and Carruthers,Some Modern Methods of Organic Synthesis, 3^(rd) Edition, CambridgeUniversity Press, Cambridge, 1987.

Compounds described herein can comprise one or more asymmetric centers,and thus can exist in various stereoisomeric forms, e.g., enantiomersand/or diastereomers. For example, the compounds described herein can bein the form of an individual enantiomer, diastereomer or geometricisomer, or can be in the form of a mixture of stereoisomers, includingracemic mixtures and mixtures enriched in one or more stereoisomer.Isomers can be isolated from mixtures by methods known to those skilledin the art, including chiral high pressure liquid chromatography (HPLC)and the formation and crystallization of chiral salts; or preferredisomers can be prepared by asymmetric syntheses. See, for example,Jacques et al., Enantiomers, Racemates and Resolutions (WileyInterscience, New York, 1981); Wilen et al., Tetrahedron 33:2725 (1977);Eliel, E. L. Stereochemistry of Carbon Compounds (McGraw-Hill, NY,1962); and Wilen, S. H. Tables of Resolving Agents and OpticalResolutions p. 268 (E. L. Eliel, Ed., Univ. of Notre Dame Press, NotreDame, Ind. 1972). The invention additionally encompasses compounds asindividual isomers substantially free of other isomers, andalternatively, as mixtures of various isomers.

When a range of values is listed, it is intended to encompass each valueand sub-range within the range. For example “C₁₋₆alkyl” is intended toencompass, C₁, C₂, C₃, C₄, C₅, C₆, C₁₋₆, C₁₋₅, C₁₋₄, C₁₋₃, C₁₋₂, C₂₋₆,C₂₋₅, C₂₋₄, C₂₋₃, C₃₋₆, C₃₋₅, C₃₋₄, C₄₋₆, C₄₋₅, and C₅₋₆ alkyl.

As used herein, “alkyl” refers to a radical of a straight-chain orbranched saturated hydrocarbon group having from 1 to 10 carbon atoms(“C₁₋₁₀ alkyl”). In some embodiments, an alkyl group has 1 to 9 carbonatoms (“C₁₋₉alkyl”). In some embodiments, an alkyl group has 1 to 8carbon atoms (“C₁₋₈ alkyl”). In some embodiments, an alkyl group has 1to 7 carbon atoms (“C₁₋₇alkyl”). In some embodiments, an alkyl group has1 to 6 carbon atoms (“C₁₋₆ alkyl”). In some embodiments, an alkyl grouphas 1 to 5 carbon atoms (“C₁₋₅alkyl”). In some embodiments, an alkylgroup has 1 to 4 carbon atoms (“C₁₋₄alkyl”). In some embodiments, analkyl group has 1 to 3 carbon atoms (“C₁₋₃alkyl”). In some embodiments,an alkyl group has 1 to 2 carbon atoms (“C₁₋₂alkyl”). In someembodiments, an alkyl group has 1 carbon atom (“C₁ alkyl”). In someembodiments, an alkyl group has 2 to 6 carbon atoms (“C₂₋₆ alkyl”).Examples of C₁₋₆ alkyl groups include methyl (C₁), ethyl (C₂), n-propyl(C₃), isopropyl (C₃), n-butyl (C₄), tert-butyl (C₄), sec-butyl (C₄),iso-butyl (C₄), n-pentyl (C₅), 3-pentanyl (C₅), amyl (C₅), neopentyl(C₅), 3-methyl-2-butanyl (C₅), tertiary amyl (C₅), and n-hexyl (C₆).Additional examples of alkyl groups include n-heptyl (C₇), n-octyl (C₈)and the like. Unless otherwise specified, each instance of an alkylgroup is independently unsubstituted (an “unsubstituted alkyl”) orsubstituted (a “substituted alkyl”) with one or more substituents. Incertain embodiments, the alkyl group is an unsubstituted C₁₋₁₀ alkyl(e.g., —CH₃). In certain embodiments, the alkyl group is a substitutedC₁₋₁₀ alkyl.

As used herein, “haloalkyl” is a substituted alkyl group as definedherein wherein one or more of the hydrogen atoms are independentlyreplaced by a halogen, e.g., fluoro, bromo, chloro, or iodo.“Perhaloalkyl” is a subset of haloalkyl, and refers to an alkyl groupwherein all of the hydrogen atoms are independently replaced by ahalogen, e.g., fluoro, bromo, chloro, or iodo. In some embodiments, thehaloalkyl moiety has 1 to 8 carbon atoms (“C₁₋₈ haloalkyl”). In someembodiments, the haloalkyl moiety has 1 to 6 carbon atoms (“C₁₋₆haloalkyl”). In some embodiments, the haloalkyl moiety has 1 to 4 carbonatoms (“C₁₋₄ haloalkyl”). In some embodiments, the haloalkyl moiety has1 to 3 carbon atoms (“C₁₋₃ haloalkyl”). In some embodiments, thehaloalkyl moiety has 1 to 2 carbon atoms (“C₁₋₂ haloalkyl”). In someembodiments, all of the haloalkyl hydrogen atoms are replaced withfluoro to provide a perfluoroalkyl group. In some embodiments, all ofthe haloalkyl hydrogen atoms are replaced with chloro to provide a“perchloroalkyl” group. Examples of haloalkyl groups include —CF₃,—CF₂CF₃, —CF₂CF₂CF₃, —CCl₃, —CFCl₂, —CF₂Cl, and the like.

As used herein, “heteroalkyl” refers to an alkyl group as defined hereinwhich further includes at least one heteroatom (e.g., 1, 2, 3, or 4heteroatoms) selected from oxygen, nitrogen, or sulfur within (i.e.,inserted between adjacent carbon atoms of) and/or placed at one or moreterminal position(s) of the parent chain. In certain embodiments, aheteroalkyl group refers to a saturated group having from 1 to 10 carbonatoms and 1 or more heteroatoms within the parent chain (“heteroC₁₋₁₀alkyl”). In some embodiments, a heteroalkyl group is a saturated grouphaving 1 to 9 carbon atoms and 1 or more heteroatoms within the parentchain (“heteroC₁₋₉ alkyl”). In some embodiments, a heteroalkyl group isa saturated group having 1 to 8 carbon atoms and 1 or more heteroatomswithin the parent chain (“heteroC₁₋₈ alkyl”). In some embodiments, aheteroalkyl group is a saturated group having 1 to 7 carbon atoms and 1or more heteroatoms within the parent chain (“heteroC₁₋₇ alkyl”). Insome embodiments, a heteroalkyl group is a saturated group having 1 to 6carbon atoms and 1 or more heteroatoms within the parent chain(“heteroC₁₋₆ alkyl”). In some embodiments, a heteroalkyl group is asaturated group having 1 to 5 carbon atoms and 1 or 2 heteroatoms withinthe parent chain (“heteroC₁₋₅ alkyl”). In some embodiments, aheteroalkyl group is a saturated group having 1 to 4 carbon atoms and 1or 2 heteroatoms within the parent chain (“heteroC₁₋₄alkyl”). In someembodiments, a heteroalkyl group is a saturated group having 1 to 3carbon atoms and 1 heteroatom within the parent chain (“heteroC₁₋₃alkyl”). In some embodiments, a heteroalkyl group is a saturated grouphaving 1 to 2 carbon atoms and 1 heteroatom within the parent chain(“heteroC₁₋₂ alkyl”). In some embodiments, a heteroalkyl group is asaturated group having 1 carbon atom and 1 heteroatom (“heteroC₁alkyl”). In some embodiments, a heteroalkyl group is a saturated grouphaving 2 to 6 carbon atoms and 1 or 2 heteroatoms within the parentchain (“heteroC₂₋₆ alkyl”). Unless otherwise specified, each instance ofa heteroalkyl group is independently unsubstituted (an “unsubstitutedheteroalkyl”) or substituted (a “substituted heteroalkyl”) with one ormore substituents. In certain embodiments, the heteroalkyl group is anunsubstituted heteroC₁₋₁₀ alkyl. In certain embodiments, the heteroalkylgroup is a substituted heteroC₁₋₁₀ alkyl.

As used herein, “alkenyl” refers to a radical of a straight-chain orbranched hydrocarbon group having from 2 to 10 carbon atoms and one ormore carbon-carbon double bonds (e.g., 1, 2, 3, or 4 double bonds). Insome embodiments, an alkenyl group has 2 to 9 carbon atoms (“C₂₋₉alkenyl”). In some embodiments, an alkenyl group has 2 to 8 carbon atoms(“C₂₋₈ alkenyl”). In some embodiments, an alkenyl group has 2 to 7carbon atoms (“C₂₋₇ alkenyl”). In some embodiments, an alkenyl group has2 to 6 carbon atoms (“C₂₋₆ alkenyl”). In some embodiments, an alkenylgroup has 2 to 5 carbon atoms (“C₂₋₅alkenyl”). In some embodiments, analkenyl group has 2 to 4 carbon atoms (“C₂₋₄ alkenyl”). In someembodiments, an alkenyl group has 2 to 3 carbon atoms (“C₂₋₃ alkenyl”).In some embodiments, an alkenyl group has 2 carbon atoms (“C₂ alkenyl”).The one or more carbon-carbon double bonds can be internal (such as in2-butenyl) or terminal (such as in 1-butenyl). Examples of C₂₋₄ alkenylgroups include ethenyl (C₂), 1-propenyl (C₃), 2-propenyl (C₃), 1-butenyl(C₄), 2-butenyl (C₄), butadienyl (C₄), and the like. Examples of C₂₋₆alkenyl groups include the aforementioned C₂₋₄ alkenyl groups as well aspentenyl (C₅), pentadienyl (C₅), hexenyl (C₆), and the like. Additionalexamples of alkenyl include heptenyl (C₇), octenyl (C₈), octatrienyl(C₈), and the like. Unless otherwise specified, each instance of analkenyl group is independently unsubstituted (an “unsubstitutedalkenyl”) or substituted (a “substituted alkenyl”) with one or moresubstituents. In certain embodiments, the alkenyl group is anunsubstituted C₂₋₁₀ alkenyl. In certain embodiments, the alkenyl groupis a substituted C₂₋₁₀ alkenyl.

As used herein, “heteroalkenyl” refers to an alkenyl group as definedherein which further includes at least one heteroatom (e.g., 1, 2, 3, or4 heteroatoms) selected from oxygen, nitrogen, or sulfur within (i.e.,inserted between adjacent carbon atoms of) and/or placed at one or moreterminal position(s) of the parent chain. In certain embodiments, aheteroalkenyl group refers to a group having from 2 to 10 carbon atoms,at least one double bond, and 1 or more heteroatoms within the parentchain (“heteroC₂₋₁₀ alkenyl”). In some embodiments, a heteroalkenylgroup has 2 to 9 carbon atoms at least one double bond, and 1 or moreheteroatoms within the parent chain (“heteroC₂₋₉ alkenyl”). In someembodiments, a heteroalkenyl group has 2 to 8 carbon atoms, at least onedouble bond, and 1 or more heteroatoms within the parent chain(“heteroC₂₋₈ alkenyl”). In some embodiments, a heteroalkenyl group has 2to 7 carbon atoms, at least one double bond, and 1 or more heteroatomswithin the parent chain (“heteroC₂₋₇ alkenyl”). In some embodiments, aheteroalkenyl group has 2 to 6 carbon atoms, at least one double bond,and 1 or more heteroatoms within the parent chain (“heteroC₂₋₆alkenyl”). In some embodiments, a heteroalkenyl group has 2 to 5 carbonatoms, at least one double bond, and 1 or 2 heteroatoms within theparent chain (“heteroC₂₋₅ alkenyl”). In some embodiments, aheteroalkenyl group has 2 to 4 carbon atoms, at least one double bond,and 1 or 2 heteroatoms within the parent chain (“heteroC₂₋₄ alkenyl”).In some embodiments, a heteroalkenyl group has 2 to 3 carbon atoms, atleast one double bond, and 1 heteroatom within the parent chain(“heteroC₂₋₃ alkenyl”). In some embodiments, a heteroalkenyl group has 2to 6 carbon atoms, at least one double bond, and 1 or 2 heteroatomswithin the parent chain (“heteroC₂₋₆ alkenyl”). Unless otherwisespecified, each instance of a heteroalkenyl group is independentlyunsubstituted (an “unsubstituted heteroalkenyl”) or substituted (a“substituted heteroalkenyl”) with one or more substituents. In certainembodiments, the heteroalkenyl group is an unsubstituted heteroC₂₋₁₀alkenyl. In certain embodiments, the heteroalkenyl group is asubstituted heteroC₂₋₁₀ alkenyl.

As used herein, “alkynyl” refers to a radical of a straight-chain orbranched hydrocarbon group having from 2 to 10 carbon atoms and one ormore carbon-carbon triple bonds (e.g., 1, 2, 3, or 4 triple bonds)(“C₂₋₁₀ alkynyl”). In some embodiments, an alkynyl group has 2 to 9carbon atoms (“C₂₋₉ alkynyl”). In some embodiments, an alkynyl group has2 to 8 carbon atoms (“C₂₋₈ alkynyl”). In some embodiments, an alkynylgroup has 2 to 7 carbon atoms (“C₂₋₇ alkynyl”). In some embodiments, analkynyl group has 2 to 6 carbon atoms (“C₂₋₆ alkynyl”). In someembodiments, an alkynyl group has 2 to 5 carbon atoms (“C₂₋₅ alkynyl”).In some embodiments, an alkynyl group has 2 to 4 carbon atoms (“C₂₋₄alkynyl”). In some embodiments, an alkynyl group has 2 to 3 carbon atoms(“C₂₋₃ alkynyl”). In some embodiments, an alkynyl group has 2 carbonatoms (“C₂ alkynyl”). The one or more carbon-carbon triple bonds can beinternal (such as in 2-butynyl) or terminal (such as in 1-butynyl).Examples of C₂₋₄ alkynyl groups include, without limitation, ethynyl(C₂), 1-propynyl (C₃), 2-propynyl (C₃), 1-butynyl (C₄), 2-butynyl (C₄),and the like. Examples of C₂₋₆ alkenyl groups include the aforementionedC₂₋₄ alkynyl groups as well as pentynyl (C₅), hexynyl (C₆), and thelike. Additional examples of alkynyl include heptynyl (C₇), octynyl(C₈), and the like. Unless otherwise specified, each instance of analkynyl group is independently unsubstituted (an “unsubstitutedalkynyl”) or substituted (a “substituted alkynyl”) with one or moresubstituents. In certain embodiments, the alkynyl group is anunsubstituted C₂₋₁₀ alkynyl. In certain embodiments, the alkynyl groupis a substituted C₂₋₁₀ alkynyl.

As used herein, “heteroalkynyl” refers to an alkynyl group as definedherein which further includes at least one heteroatom (e.g., 1, 2, 3, or4 heteroatoms) selected from oxygen, nitrogen, or sulfur within (i.e.,inserted between adjacent carbon atoms of) and/or placed at one or moreterminal position(s) of the parent chain. In certain embodiments, aheteroalkynyl group refers to a group having from 2 to 10 carbon atoms,at least one triple bond, and 1 or more heteroatoms within the parentchain (“heteroC₂₋₁₀ alkynyl”). In some embodiments, a heteroalkynylgroup has 2 to 9 carbon atoms, at least one triple bond, and 1 or moreheteroatoms within the parent chain (“heteroC₂₋₉ alkynyl”). In someembodiments, a heteroalkynyl group has 2 to 8 carbon atoms, at least onetriple bond, and 1 or more heteroatoms within the parent chain(“heteroC₂₋₈ alkynyl”). In some embodiments, a heteroalkynyl group has 2to 7 carbon atoms, at least one triple bond, and 1 or more heteroatomswithin the parent chain (“heteroC₂₋₇ alkynyl”). In some embodiments, aheteroalkynyl group has 2 to 6 carbon atoms, at least one triple bond,and 1 or more heteroatoms within the parent chain (“heteroC₂₋₆alkynyl”). In some embodiments, a heteroalkynyl group has 2 to 5 carbonatoms, at least one triple bond, and 1 or 2 heteroatoms within theparent chain (“heteroC₂₋₅ alkynyl”). In some embodiments, aheteroalkynyl group has 2 to 4 carbon atoms, at least one triple bond,and 1 or 2 heteroatoms within the parent chain (“heteroC₂₋₄ alkynyl”).In some embodiments, a heteroalkynyl group has 2 to 3 carbon atoms, atleast one triple bond, and 1 heteroatom within the parent chain(“heteroC₂₋₃ alkynyl”). In some embodiments, a heteroalkynyl group has 2to 6 carbon atoms, at least one triple bond, and 1 or 2 heteroatomswithin the parent chain (“heteroC₂₋₆ alkynyl”). Unless otherwisespecified, each instance of a heteroalkynyl group is independentlyunsubstituted (an “unsubstituted heteroalkynyl”) or substituted (a“substituted heteroalkynyl”) with one or more substituents. In certainembodiments, the heteroalkynyl group is an unsubstituted heteroC₂₋₁₀alkynyl. In certain embodiments, the heteroalkynyl group is asubstituted heteroC₂₋₁₀ alkynyl.

As used herein, “carbocyclyl” or “carbocyclic” refers to a radical of anon-aromatic cyclic hydrocarbon group having from 3 to 10 ring carbonatoms (“C₃₀₋₁₀ carbocyclyl”) and zero heteroatoms in the non-aromaticring system. In some embodiments, a carbocyclyl group has 3 to 8 ringcarbon atoms (“C₃₋₈ carbocyclyl”). In some embodiments, a carbocyclylgroup has 3 to 7 ring carbon atoms (“C₃₋₇ carbocyclyl”). In someembodiments, a carbocyclyl group has 3 to 6 ring carbon atoms (“C₃₋₆carbocyclyl”). In some embodiments, a carbocyclyl group has 4 to 6 ringcarbon atoms (“C₄₋₆ carbocyclyl”). In some embodiments, a carbocyclylgroup has 5 to 6 ring carbon atoms (“C₅₋₆ carbocyclyl”). In someembodiments, a carbocyclyl group has 5 to 10 ring carbon atoms (“C₅₋₁₀carbocyclyl”). Exemplary C₃₋₆ carbocyclyl groups include, withoutlimitation, cyclopropyl (C₃), cyclopropenyl (C₃), cyclobutyl (C₄),cyclobutenyl (C₄), cyclopentyl (C₅), cyclopentenyl (C₅), cyclohexyl(C₆), cyclohexenyl (C₆), cyclohexadienyl (C₆), and the like. ExemplaryC₃₋₈ carbocyclyl groups include, without limitation, the aforementionedC₃₋₆ carbocyclyl groups as well as cycloheptyl (C₇), cycloheptenyl (C₇),cycloheptadienyl (C₇), cycloheptatrienyl (C₇), cyclooctyl (C₈),cyclooctenyl (C₈), bicyclo[2.2.1]heptanyl (C₇), bicyclo[2.2.2]octanyl(C₈), and the like. Exemplary C₃₋₁₀ carbocyclyl groups include, withoutlimitation, the aforementioned C₃₋₈ carbocyclyl groups as well ascyclononyl (C₉), cyclononenyl (C₉), cyclodecyl (C₁₀), cyclodecenyl(C₁₀), octahydro-1H-indenyl (C₉), decahydronaphthalenyl (C₁₀),spiro[4.5]decanyl (C₁₀), and the like. As the foregoing examplesillustrate, in certain embodiments, the carbocyclyl group is eithermonocyclic (“monocyclic carbocyclyl”) or polycyclic (e.g., containing afused, bridged or spiro ring system such as a bicyclic system (“bicycliccarbocyclyl”) or tricyclic system (“tricyclic carbocyclyl”)) and can besaturated or can contain one or more carbon-carbon double or triplebonds. “Carbocyclyl” also includes ring systems wherein the carbocyclylring, as defined above, is fused with one or more aryl or heteroarylgroups wherein the point of attachment is on the carbocyclyl ring, andin such instances, the number of carbons continue to designate thenumber of carbons in the carbocyclic ring system. Unless otherwisespecified, each instance of a carbocyclyl group is independentlyunsubstituted (an “unsubstituted carbocyclyl”) or substituted (a“substituted carbocyclyl”) with one or more substituents. In certainembodiments, the carbocyclyl group is an unsubstituted C₃₋₁₀carbocyclyl. In certain embodiments, the carbocyclyl group is asubstituted C₃₋₁₀ carbocyclyl.

In some embodiments, “carbocyclyl” is a monocyclic, saturatedcarbocyclyl group having from 3 to 10 ring carbon atoms (“C₃₋₁₀cycloalkyl”). In some embodiments, a cycloalkyl group has 3 to 8 ringcarbon atoms (“C₃₋₈ cycloalkyl”). In some embodiments, a cycloalkylgroup has 3 to 6 ring carbon atoms (“C₃₋₆ cycloalkyl”). In someembodiments, a cycloalkyl group has 4 to 6 ring carbon atoms (“C₄₋₆cycloalkyl”). In some embodiments, a cycloalkyl group has 5 to 6 ringcarbon atoms (“C₅₋₆ cycloalkyl”). In some embodiments, a cycloalkylgroup has 5 to 10 ring carbon atoms (“C₅₋₁₀ cycloalkyl”). Examples ofC₅₋₆ cycloalkyl groups include cyclopentyl (C₅) and cyclohexyl (C₅).Examples of C₃₋₆ cycloalkyl groups include the aforementioned C₅₋₆cycloalkyl groups as well as cyclopropyl (C₃) and cyclobutyl (C₄).Examples of C₃₋₈ cycloalkyl groups include the aforementioned C₃₋₆cycloalkyl groups as well as cycloheptyl (C₇) and cyclooctyl (C₈).Unless otherwise specified, each instance of a cycloalkyl group isindependently unsubstituted (an “unsubstituted cycloalkyl”) orsubstituted (a “substituted cycloalkyl”) with one or more substituents.In certain embodiments, the cycloalkyl group is an unsubstituted C₃₋₁₀cycloalkyl. In certain embodiments, the cycloalkyl group is asubstituted C₃₋₁₀ cycloalkyl.

As used herein, “heterocyclyl” or “heterocyclic” refers to a radical ofa 3- to 14-membered non-aromatic ring system having ring carbon atomsand 1 to 4 ring heteroatoms, wherein each heteroatom is independentlyselected from nitrogen, oxygen, and sulfur (“3-14 memberedheterocyclyl”). In heterocyclyl groups that contain one or more nitrogenatoms, the point of attachment can be a carbon or nitrogen atom, asvalency permits. A heterocyclyl group can either be monocyclic(“monocyclic heterocyclyl”) or polycyclic (e.g., a fused, bridged orspiro ring system such as a bicyclic system (“bicyclic heterocyclyl”) ortricyclic system (“tricyclic heterocyclyl”)), and can be saturated orcan contain one or more carbon-carbon double or triple bonds.Heterocyclyl polycyclic ring systems can include one or more heteroatomsin one or both rings. “Heterocyclyl” also includes ring systems whereinthe heterocyclyl ring, as defined above, is fused with one or morecarbocyclyl groups wherein the point of attachment is either on thecarbocyclyl or heterocyclyl ring, or ring systems wherein theheterocyclyl ring, as defined above, is fused with one or more aryl orheteroaryl groups, wherein the point of attachment is on theheterocyclyl ring, and in such instances, the number of ring memberscontinue to designate the number of ring members in the heterocyclylring system. Unless otherwise specified, each instance of heterocyclylis independently unsubstituted (an “unsubstituted heterocyclyl”) orsubstituted (a “substituted heterocyclyl”) with one or moresubstituents. In certain embodiments, the heterocyclyl group is anunsubstituted 3-14 membered heterocyclyl. In certain embodiments, theheterocyclyl group is a substituted 3-14 membered heterocyclyl.

In some embodiments, a heterocyclyl group is a 5-10 memberednon-aromatic ring system having ring carbon atoms and 1-4 ringheteroatoms, wherein each heteroatom is independently selected fromnitrogen, oxygen, and sulfur (“5-10 membered heterocyclyl”). In someembodiments, a heterocyclyl group is a 5-8 membered non-aromatic ringsystem having ring carbon atoms and 1-4 ring heteroatoms, wherein eachheteroatom is independently selected from nitrogen, oxygen, and sulfur(“5-8 membered heterocyclyl”). In some embodiments, a heterocyclyl groupis a 5-6 membered non-aromatic ring system having ring carbon atoms and1-4 ring heteroatoms, wherein each heteroatom is independently selectedfrom nitrogen, oxygen, and sulfur (“5-6 membered heterocyclyl”). In someembodiments, the 5-6 membered heterocyclyl has 1-3 ring heteroatomsselected from nitrogen, oxygen, and sulfur. In some embodiments, the 5-6membered heterocyclyl has 1-2 ring heteroatoms selected from nitrogen,oxygen, and sulfur. In some embodiments, the 5-6 membered heterocyclylhas 1 ring heteroatom selected from nitrogen, oxygen, and sulfur.

Exemplary 3-membered heterocyclyl groups containing 1 heteroatominclude, without limitation, azirdinyl, oxiranyl, thiorenyl. Exemplary4-membered heterocyclyl groups containing 1 heteroatom include, withoutlimitation, azetidinyl, oxetanyl and thietanyl. Exemplary 5-memberedheterocyclyl groups containing 1 heteroatom include, without limitation,tetrahydrofuranyl, dihydrofuranyl, tetrahydrothiophenyl,dihydrothiophenyl, pyrrolidinyl, dihydropyrrolyl and pyrrolyl-2,5-dione.Exemplary 5-membered heterocyclyl groups containing 2 heteroatomsinclude, without limitation, dioxolanyl, oxathiolanyl and dithiolanyl.Exemplary 5-membered heterocyclyl groups containing 3 heteroatomsinclude, without limitation, triazolinyl, oxadiazolinyl, andthiadiazolinyl. Exemplary 6-membered heterocyclyl groups containing 1heteroatom include, without limitation, piperidinyl, tetrahydropyranyl,dihydropyranyl, dihydropyridinyl, and thianyl. Exemplary 6-memberedheterocyclyl groups containing 2 heteroatoms include, withoutlimitation, piperazinyl, morpholinyl, dithianyl, dioxanyl. Exemplary6-membered heterocyclyl groups containing 2 heteroatoms include, withoutlimitation, triazinanyl. Exemplary 7-membered heterocyclyl groupscontaining 1 heteroatom include, without limitation, azepanyl, oxepanyland thiepanyl. Exemplary 8-membered heterocyclyl groups containing 1heteroatom include, without limitation, azocanyl, oxecanyl andthiocanyl. Exemplary bicyclic heterocyclyl groups include, withoutlimitation, indolinyl, isoindolinyl, dihydrobenzofuranyl,dihydrobenzothienyl, tetra-hydrobenzothienyl, tetrahydrobenzofuranyl,tetrahydroindolyl, tetrahydroquinolinyl, tetrahydroisoquinolinyl,decahydroquinolinyl, decahydroisoquinolinyl, octahydrochromenyl,octahydroisochromenyl, decahydronaphthyridinyl,decahydro-1,8-naphthyridinyl, octahydropyrrolo[3,2-b]pyrrole, indolinyl,phthalimidyl, naphthalimidyl, chromanyl, chromenyl,1H-benzo[e][1,4]diazepinyl, 1,4,5,7-tetrahydropyrano[3,4-b]pyrrolyl,5,6-dihydro-4H-furo[3,2-b]pyrrolyl, 6,7-dihydro-5H-furo[3,2-b]pyranyl,5,7-dihydro-4H-thieno[2,3-c]pyranyl,2,3-dihydro-1H-pyrrolo[2,3-b]pyridinyl, 2,3-dihydrofuro[2,3-b]pyridinyl,4,5,6,7-tetrahydro-1H-pyrrolo[2,3-b]pyridinyl,4,5,6,7-tetrahydrofuro[3,2-c]pyridinyl,4,5,6,7-tetrahydrothieno[3,2-b]pyridinyl,1,2,3,4-tetrahydro-1,6-naphthyridinyl, and the like.

As used herein, “aryl” refers to a radical of a monocyclic or polycyclic(e.g., bicyclic or tricyclic) 4n+2 aromatic ring system (e.g., having 6,10, or 14 π electrons shared in a cyclic array) having 6-14 ring carbonatoms and zero heteroatoms provided in the aromatic ring system (“C₆₋₁₄aryl”). In some embodiments, an aryl group has 6 ring carbon atoms (“C₆aryl”; e.g., phenyl). In some embodiments, an aryl group has 10 ringcarbon atoms (“C₁₀ aryl”; e.g., naphthyl such as 1-naphthyl and2-naphthyl). In some embodiments, an aryl group has 14 ring carbon atoms(“C₁₄ aryl”; e.g., anthracyl). “Aryl” also includes ring systems whereinthe aryl ring, as defined above, is fused with one or more carbocyclylor heterocyclyl groups wherein the radical or point of attachment is onthe aryl ring, and in such instances, the number of carbon atomscontinue to designate the number of carbon atoms in the aryl ringsystem. Unless otherwise specified, each instance of an aryl group isindependently unsubstituted (an “unsubstituted aryl”) or substituted (a“substituted aryl”) with one or more substituents. In certainembodiments, the aryl group is an unsubstituted C₆₋₁₄ aryl. In certainembodiments, the aryl group is a substituted C₆₋₁₄ aryl.

As used herein, “heteroaryl” refers to a radical of a 5-14 memberedmonocyclic or polycyclic (e.g., bicyclic, tricyclic) 4n+2 aromatic ringsystem (e.g., having 6, 10, or 14 π electrons shared in a cyclic array)having ring carbon atoms and 1-4 ring heteroatoms provided in thearomatic ring system, wherein each heteroatom is independently selectedfrom nitrogen, oxygen and sulfur (“5-14 membered heteroaryl”). Inheteroaryl groups that contain one or more nitrogen atoms, the point ofattachment can be a carbon or nitrogen atom, as valency permits.Heteroaryl polycyclic ring systems can include one or more heteroatomsin one or both rings. “Heteroaryl” includes ring systems wherein theheteroaryl ring, as defined above, is fused with one or more carbocyclylor heterocyclyl groups wherein the point of attachment is on theheteroaryl ring, and in such instances, the number of ring memberscontinue to designate the number of ring members in the heteroaryl ringsystem. “Heteroaryl” also includes ring systems wherein the heteroarylring, as defined above, is fused with one or more aryl groups whereinthe point of attachment is either on the aryl or heteroaryl ring, and insuch instances, the number of ring members designates the number of ringmembers in the fused polycyclic (aryl/heteroaryl) ring system.Polycyclic heteroaryl groups wherein one ring does not contain aheteroatom (e.g., indolyl, quinolinyl, carbazolyl, and the like) thepoint of attachment can be on either ring, i.e., either the ring bearinga heteroatom (e.g., 2-indolyl) or the ring that does not contain aheteroatom (e.g., 5-indolyl).

In some embodiments, a heteroaryl group is a 5-10 membered aromatic ringsystem having ring carbon atoms and 1-4 ring heteroatoms provided in thearomatic ring system, wherein each heteroatom is independently selectedfrom nitrogen, oxygen, and sulfur (“5-10 membered heteroaryl”). In someembodiments, a heteroaryl group is a 5-8 membered aromatic ring systemhaving ring carbon atoms and 1-4 ring heteroatoms provided in thearomatic ring system, wherein each heteroatom is independently selectedfrom nitrogen, oxygen, and sulfur (“5-8 membered heteroaryl”). In someembodiments, a heteroaryl group is a 5-6 membered aromatic ring systemhaving ring carbon atoms and 1-4 ring heteroatoms provided in thearomatic ring system, wherein each heteroatom is independently selectedfrom nitrogen, oxygen, and sulfur (“5-6 membered heteroaryl”). In someembodiments, the 5-6 membered heteroaryl has 1-3 ring heteroatomsselected from nitrogen, oxygen, and sulfur. In some embodiments, the 5-6membered heteroaryl has 1-2 ring heteroatoms selected from nitrogen,oxygen, and sulfur. In some embodiments, the 5-6 membered heteroaryl has1 ring heteroatom selected from nitrogen, oxygen, and sulfur. Unlessotherwise specified, each instance of a heteroaryl group isindependently unsubstituted (an “unsubstituted heteroaryl”) orsubstituted (a “substituted heteroaryl”) with one or more substituents.In certain embodiments, the heteroaryl group is an unsubstituted 5-14membered heteroaryl. In certain embodiments, the heteroaryl group is asubstituted 5-14 membered heteroaryl.

Exemplary 5-membered heteroaryl groups containing 1 heteroatom include,without limitation, pyrrolyl, furanyl and thiophenyl. Exemplary5-membered heteroaryl groups containing 2 heteroatoms include, withoutlimitation, imidazolyl, pyrazolyl, oxazolyl, isoxazolyl, thiazolyl, andisothiazolyl. Exemplary 5-membered heteroaryl groups containing 3heteroatoms include, without limitation, triazolyl, oxadiazolyl, andthiadiazolyl. Exemplary 5-membered heteroaryl groups containing 4heteroatoms include, without limitation, tetrazolyl. Exemplary6-membered heteroaryl groups containing 1 heteroatom include, withoutlimitation, pyridinyl. Exemplary 6-membered heteroaryl groups containing2 heteroatoms include, without limitation, pyridazinyl, pyrimidinyl, andpyrazinyl. Exemplary 6-membered heteroaryl groups containing 3 or 4heteroatoms include, without limitation, triazinyl and tetrazinyl,respectively. Exemplary 7-membered heteroaryl groups containing 1heteroatom include, without limitation, azepinyl, oxepinyl, andthiepinyl. Exemplary 5,6-bicyclic heteroaryl groups include, withoutlimitation, indolyl, isoindolyl, indazolyl, benzotriazolyl,benzothiophenyl, isobenzothiophenyl, benzofuranyl, benzoisofuranyl,benzimidazolyl, benzoxazolyl, benzisoxazolyl, benzoxadiazolyl,benzthiazolyl, benzisothiazolyl, benzthiadiazolyl, indolizinyl, andpurinyl. Exemplary 6,6-bicyclic heteroaryl groups include, withoutlimitation, naphthyridinyl, pteridinyl, quinolinyl, isoquinolinyl,cinnolinyl, quinoxalinyl, phthalazinyl, and quinazolinyl. Exemplarytricyclic heteroaryl groups include, without limitation,phenanthridinyl, dibenzofuranyl, carbazolyl, acridinyl, phenothiazinyl,phenoxazinyl and phenazinyl.

As used herein, the term “partially unsaturated” refers to a ring moietythat includes at least one double or triple bond. The term “partiallyunsaturated” is intended to encompass rings having multiple sites ofunsaturation, but is not intended to include aromatic groups (e.g., arylor heteroaryl moieties) as herein defined.

As used herein, the term “saturated” refers to a ring moiety that doesnot contain a double or triple bond, i.e., the ring contains all singlebonds.

Affixing the suffix “-ene” to a group indicates the group is a divalentmoiety, e.g., alkylene is the divalent moiety of alkyl, alkenylene isthe divalent moiety of alkenyl, alkynylene is the divalent moiety ofalkynyl, heteroalkylene is the divalent moiety of heteroalkyl,heteroalkenylene is the divalent moiety of heteroalkenyl,heteroalkynylene is the divalent moiety of heteroalkynyl, carbocyclyleneis the divalent moiety of carbocyclyl, heterocyclylene is the divalentmoiety of heterocyclyl, arylene is the divalent moiety of aryl, andheteroarylene is the divalent moiety of heteroaryl.

As understood from the above, alkyl, alkenyl, alkynyl, heteroalkyl,heteroalkenyl, heteroalkynyl, carbocyclyl, heterocyclyl, aryl, andheteroaryl groups, as defined herein, are, in certain embodiments,optionally substituted. Optionally substituted refers to a group whichmay be substituted or unsubstituted (e.g., “substituted” or“unsubstituted” alkyl, “substituted” or “unsubstituted” alkenyl,“substituted” or “unsubstituted” alkynyl, “substituted” or“unsubstituted” heteroalkyl, “substituted” or “unsubstituted”heteroalkenyl, “substituted” or “unsubstituted” heteroalkynyl,“substituted” or “unsubstituted” carbocyclyl, “substituted” or“unsubstituted” heterocyclyl, “substituted” or “unsubstituted” aryl or“substituted” or “unsubstituted” heteroaryl group). In general, the term“substituted” means that at least one hydrogen present on a group isreplaced with a permissible substituent, e.g., a substituent which uponsubstitution results in a stable compound, e.g., a compound which doesnot spontaneously undergo transformation such as by rearrangement,cyclization, elimination, or other reaction. Unless otherwise indicated,a “substituted” group has a substituent at one or more substitutablepositions of the group, and when more than one position in any givenstructure is substituted, the substituent is either the same ordifferent at each position. The term “substituted” is contemplated toinclude substitution with all permissible substituents of organiccompounds, any of the substituents described herein that results in theformation of a stable compound. The present invention contemplates anyand all such combinations in order to arrive at a stable compound. Forpurposes of this invention, heteroatoms such as nitrogen may havehydrogen substituents and/or any suitable substituent as describedherein which satisfy the valencies of the heteroatoms and results in theformation of a stable moiety.

Exemplary carbon atom substituents include, but are not limited to,halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(aa), —ON(R^(bb))₂,—N(R^(bb))₂, —N(R^(bb))₃ ⁺X⁻, —N(OR^(cc))R^(bb), —SH, —SR^(aa),—SSR^(cc), —C(═O)R^(aa), —CO₂H, —CHO, —C(OR^(cc))₂, —CO₂R^(aa),—OC(═O)R^(aa), —OCO₂R^(aa), —C(═O)N(R^(bb))₂, —OC(═O)N(R^(bb))₂,—NR^(bb)C(═O)R^(aa), —NR^(bb)CO₂R^(aa), —NR^(bb)C(═O)N(R^(bb))₂,—C(═NR^(bb))R^(aa), —C(═NR^(bb))OR^(aa), —OC(═NR^(bb))R^(aa),—OC(═NR^(bb))OR^(aa), —C(═NR^(bb))N(R^(bb))₂, —OC(═NR^(bb))N(R^(bb))₂,—NR^(bb)C(═NR^(bb))N(R^(bb))₂, —C(═O)NR^(bb)SO₂R^(aa),—NR^(bb)SO₂R^(aa), —SO₂N(R^(bb))₂, —SO₂R^(aa), —SO₂OR^(aa), —OSO₂R^(aa),—S(═O)R^(aa), —OS(═O)R^(aa), —Si(R^(aa))₃,—OSi(R^(aa))₃—C(═S)N(R^(bb))₂, —C(═O)SR^(aa), —C(═S)SR^(aa),—SC(═S)SR^(aa), —SC(═O)SR^(aa), —OC(═O)SR^(aa), —SC(═O)OR^(aa),—SC(═O)R^(aa), —P(═O)₂R^(aa), —OP(═O)₂R^(aa), —P(═O)(R^(aa))₂,—OP(═O)(R^(aa))₂, —OP(═O)(OR^(cc))₂, —P(═O)₂N(R^(bb))₂,—OP(═O)₂N(R^(bb))₂, —P(═O)(NR^(bb))₂, —OP(═O)(NR^(bb))₂,—NR^(bb)P(═O)(OR^(cc))₂, —NR^(bb)P(═O)(NR^(bb))₂, —P(R^(cc))₂,—P(R^(cc))₃, —OP(R^(cc))₂, —OP(R^(cc))₃, —B(R^(aa))₂, —B(OR^(cc))₂,—BR^(aa)(OR^(cc)), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀alkynyl, heteroC₁₋₁₀ alkyl, heteroC₂₋₁₀ alkenyl, heteroC₂₋₁₀alkynyl,C₃₋₁₄ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₄ aryl, and 5-14membered heteroaryl, wherein each alkyl, alkenyl, alkynyl, heteroalkyl,heteroalkenyl, heteroalkynyl, carbocyclyl, heterocyclyl, aryl, andheteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5 R^(dd)groups;

or two geminal hydrogens on a carbon atom are replaced with the group═O, ═S, ═NN(R^(bb))₂, ═NNR^(bb)C(═O)R^(aa), ═NNR^(bb)C(═O)OR^(aa),═NNR^(bb)S(═O)₂R^(aa), ═NR^(bb), or ═NOR^(cc);

each instance of R^(aa) is, independently, selected from C₁₋₁₀ alkyl,C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, heteroC₁₋₁₀alkyl,heteroC₂₋₁₀ alkenyl, heteroC₂₋₁₀alkynyl, C₃₋₁₀ carbocyclyl, 3-14membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or twoR^(aa) groups are joined to form a 3-14 membered heterocyclyl or 5-14membered heteroaryl ring, wherein each alkyl, alkenyl, alkynyl,heteroalkyl, heteroalkenyl, heteroalkynyl, carbocyclyl, heterocyclyl,aryl, and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or5 R^(dd) groups;

each instance of R^(bb) is, independently, selected from hydrogen, —OH,—OR^(aa), —N(R^(cc))₂, —CN, —C(═O)R^(aa), —C(═O)N(R^(cc))₂, —CO₂R^(aa),—SO₂R^(aa), —C(═NR^(cc))OR^(aa), —C(═NR^(cc))N(R^(cc))₂, —SO₂N(R^(cc))₂,—SO₂R^(cc), —SO₂OR^(cc), —SOR^(aa), —C(═S)N(R^(cc))₂, —C(═O)SR^(cc),—C(═S)SR^(cc), P(═O)₂R^(aa), —P(═O)(R^(aa))₂, —P(═O)₂N(R^(cc))₂,—P(═O)(NR^(cc))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀alkynyl, heteroC₁₋₁₀ alkyl, heteroC₂₋₁₀ alkenyl, heteroC₂₋₁₀alkynyl,C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14membered heteroaryl, or two R^(bb) groups are joined to form a 3-14membered heterocyclyl or 5-14 membered heteroaryl ring, wherein eachalkyl, alkenyl, alkynyl, heteroalkyl, heteroalkenyl, heteroalkynyl,carbocyclyl, heterocyclyl, aryl, and heteroaryl is independentlysubstituted with 0, 1, 2, 3, 4, or 5 R^(dd) groups;

each instance of R^(cc) is, independently, selected from hydrogen, C₁₋₁₀alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, heteroC₁₋₁₀alkyl, heteroC₂₋₁₀ alkenyl, heteroC₂₋₁₀alkynyl, C₃₋₁₀ carbocyclyl, 3-14membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or twoR^(cc) groups are joined to form a 3-14 membered heterocyclyl or 5-14membered heteroaryl ring, wherein each alkyl, alkenyl, alkynyl,heteroalkyl, heteroalkenyl, heteroalkynyl, carbocyclyl, heterocyclyl,aryl, and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or5 R^(dd) groups;

each instance of R^(dd) is, independently, selected from halogen, —CN,—NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(ee), —ON(R^(ff))₂, —N(R^(ff))₂,—N(R^(ff))₃ ⁺X⁻, —N(OR^(ee))R^(ff), —SH, —SR^(ee), —SSR^(ee),—C(═O)R^(ee), —CO₂H, —CO₂R^(ee), —OC(═O)R^(ee), —OCO₂R^(ee),—C(═O)N(R^(ff))₂, —OC(═O)N(R^(ff))₂, —NR^(ff)C(═O)R^(ee),—NR^(ff)CO₂R^(ee), —NR^(ff)C(═O)N(R^(ff))₂, —C(═NR^(ff))OR^(ee),—OC(═NR^(ff))R^(ee), —OC(═NR^(ff))OR^(ee), —C(═NR^(ff))N(R^(ff))₂,—OC(═NR^(ff))N(R^(ff))₂, —NR^(ff)C(═NR^(ff))N(R^(ff))₂,—NR^(ff)SO₂R^(ee)—, —SO₂N(R^(ff))₂, —SO₂R^(ee), —SO₂OR^(ee),—OSO₂R^(ee), —S(═O)R^(ee), —Si(R^(ee))₃, —OSi(R^(ee))₃,—C(═S)N(R^(ff))₂, —C(═O)SR^(ee), —C(═S)SR^(ee), —SC(═S)SR^(ee),—P(═O)₂R^(ee), —P(═O)(R^(ee))₂, —OP(═O)(R^(ee))₂, —OP(═O)(OR^(ee))₂,C₁₋₆ alkyl, C₁₋₆ perhaloalkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl, heteroC₁₋₆alkyl, heteroC₂₋₆ alkenyl, heteroC₂₋₆alkynyl, C₃₋₁₀ carbocyclyl, 3-10membered heterocyclyl, C₆₋₁₀ aryl, 5-10 membered heteroaryl, whereineach alkyl, alkenyl, alkynyl, heteroalkyl, heteroalkenyl, heteroalkynyl,carbocyclyl, heterocyclyl, aryl, and heteroaryl is independentlysubstituted with 0, 1, 2, 3, 4, or 5 R^(gg) groups, or two geminalR^(dd) substituents can be joined to form ═O or ═S;

each instance of R^(ee) is, independently, selected from C₁₋₆ alkyl,C₁₋₆ perhaloalkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl, heteroC₁₋₆ alkyl,heteroC₂₋₆ alkenyl, heteroC₂₋₆alkynyl, C₃₋₁₀ carbocyclyl, C₆₋₁₀ aryl,3-10 membered heterocyclyl, and 3-10 membered heteroaryl, wherein eachalkyl, alkenyl, alkynyl, heteroalkyl, heteroalkenyl, heteroalkynyl,carbocyclyl, heterocyclyl, aryl, and heteroaryl is independentlysubstituted with 0, 1, 2, 3, 4, or 5 R^(gg) groups;

each instance of R^(ff) is, independently, selected from hydrogen, C₁₋₆alkyl, C₁₋₆ perhaloalkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl, heteroC₁₋₆ alkyl,heteroC₂₋₆ alkenyl, heteroC₂₋₆ alkynyl, C₃₋₁₀ carbocyclyl, 3-10 memberedheterocyclyl, C₆₋₁₀ aryl and 5-10 membered heteroaryl, or two R^(ff)groups are joined to form a 3-14 membered heterocyclyl or 5-14 memberedheteroaryl ring, wherein each alkyl, alkenyl, alkynyl, heteroalkyl,heteroalkenyl, heteroalkynyl, carbocyclyl, heterocyclyl, aryl, andheteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5 R^(gg)groups; and

each instance of R^(gg) is, independently, halogen, —CN, —NO₂, —N₃,—SO₂H, —SO₃H, —OH, —OC₁₋₆ alkyl, —ON(C₁₋₆ alkyl)₂, —N(C₁₋₆ alkyl)₂,—N(C₁₋₆ alkyl)₃ ⁺X⁻, —NH(C₁₋₆ alkyl)₂ ⁺X⁻, —NH₂(C₁₋₆ alkyl)⁺X⁻, —NH₃⁺X⁻, —N(OC₁₋₆ alkyl)(C₁₋₆ alkyl), —N(OH)(C₁₋₆ alkyl), —NH(OH), —SH,—SC₁₋₆ alkyl, —SS(C₁₋₆ alkyl), —C(═O)(C₁₋₆ alkyl), —CO₂H, —CO₂(C₁₋₆alkyl), —OC(═O)(C₁₋₆ alkyl), —OCO₂(C₁₋₆ alkyl), —C(═O)NH₂, —C(═O)N(C₁₋₆alkyl)₂, —OC(═O)NH(C₁₋₆ alkyl), —NHC(═O)(C₁₋₆ alkyl), —N(C₁₋₆alkyl)C(═O)(C₁₋₆ alkyl), —NHCO₂(C₁₋₆ alkyl), —NHC(═O)N(C₁₋₆ alkyl)₂,—NHC(═O)NH(C₁₋₆ alkyl), —NHC(═O)NH₂, —C(═NH)O(C₁₋₆ alkyl), —OC(═NH)(C₁₋₆alkyl), —OC(═NH)OC₁₋₆ alkyl, —C(═NH)N(C₁₋₆ alkyl)₂, —C(═NH)NH(C₁₋₆alkyl), —C(═NH)NH₂, —OC(═NH)N(C₁₋₆ alkyl)₂, —OC(NH)NH(C₁₋₆ alkyl),—OC(NH)NH₂, —NHC(NH)N(C₁₋₆ alkyl)₂, —NHC(═NH)NH₂, —NHSO₂(C₁₋₆ alkyl),—SO₂N(C₁₋₆ alkyl)₂, —SO₂NH(C₁₋₆ alkyl), —SO₂NH₂, —SO₂C₁₋₆ alkyl,—SO₂OC₁₋₆ alkyl, —OSO₂C₁₋₆ alkyl, —SOC₁₋₆ alkyl, —Si(C₁₋₆ alkyl)₃,—OSi(C₁₋₆ alkyl)₃-C(═S)N(C₁₋₆ alkyl)₂, C(═S)NH(C₁₋₆ alkyl), C(═S)NH₂,—C(═O)S(C₁₋₆ alkyl), —C(═S)SC₁₋₆ alkyl, —SC(═S)SC₁₋₆ alkyl, —P(═O)₂(C₁₋₆alkyl), —P(═O)(C₁₋₆ alkyl)₂, —OP(═O)(C₁₋₆ alkyl)₂, —OP(═O)(OC₁₋₆alkyl)₂, C₁₋₆ alkyl, C₁₋₆ perhaloalkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl,heteroC₁₋₆ alkyl, heteroC₂₋₆ alkenyl, heteroC₂₋₆ alkynyl, C₃₋₁₀carbocyclyl, C₆₋₁₀ aryl, 3-10 membered heterocyclyl, 5-10 memberedheteroaryl; or two geminal R^(gg) substituents can be joined to form ═Oor ═S; wherein X⁻ is a counterion.

As used herein, the term “halo” or “halogen” refers to fluorine (fluoro,—F), chlorine (chloro, —Cl), bromine (bromo, —Br), or iodine (iodo, —I).

As used herein, a “counterion” is a negatively charged group associatedwith a positively charged quarternary amine in order to maintainelectronic neutrality. Exemplary counterions include halide ions (e.g.,F⁻, Cl⁻, Br⁻, I⁻), NO₃ ⁻, ClO₄ ⁻, OH⁻, H₂ ⁻PO₄ ⁻, HSO₄ ⁻, sulfonate ions(e.g., methansulfonate, trifluoromethanesulfonate, p-toluenesulfonate,benzenesulfonate, 10-camphor sulfonate, naphthalene-2-sulfonate,naphthalene-1-sulfonic acid-5-sulfonate, ethan-1-sulfonicacid-2-sulfonate, and the like), and carboxylate ions (e.g., acetate,ethanoate, propanoate, benzoate, glycerate, lactate, tartrate,glycolate, and the like).

As used herein, the term “hydroxyl” or “hydroxy” refers to the group—OH. The term “substituted hydroxyl” or “substituted hydroxyl,” byextension, refers to a hydroxyl group wherein the oxygen atom directlyattached to the parent molecule is substituted with a group other thanhydrogen, and includes groups selected from —OR^(aa), —ON(R^(bb))₂,—OC(═O)SR^(aa), —OC(═O)R^(aa), —OCO₂R^(aa), —OC(═O)N(R^(bb))₂,—OC(═NR^(bb))R^(aa), —OC(═NR^(bb))OR^(aa), —OC(═NR^(bb))N(R^(bb))₂,—OS(═O)R^(aa), —OSO₂R^(aa), —OSi(R^(aa))₃, —OP(R^(cc))₂, —OP(R^(cc))₃,—OP(═O)₂R^(aa), —OP(═O)(R^(aa))₂, —OP(═O)(OR^(cc))₂, —OP(═O)₂N(R^(bb))₂,and —OP(═O)(NR^(bb))₂, wherein R^(aa), R^(bb), and R^(cc) are as definedherein.

As used herein, the term “thiol” or “thio” refers to the group —SH. Theterm “substituted thiol” or “substituted thio,” by extension, refers toa thiol group wherein the sulfur atom directly attached to the parentmolecule is substituted with a group other than hydrogen, and includesgroups selected from —SR^(aa), —S═SR^(cc), —SC(═S)SR^(aa),—SC(═O)SR^(aa), —SC(═O)OR^(aa), and —SC(═O)R^(aa), wherein R^(aa) andR^(cc) are as defined herein.

As used herein, the term, “amino” refers to the group —NH₂. The term“substituted amino,” by extension, refers to a monosubstituted amino, adisubstituted amino, or a trisubstituted amino, as defined herein. Incertain embodiments, the “substituted amino” is a monosubstituted aminoor a disubstituted amino group.

As used herein, the term “monosubstituted amino” refers to an aminogroup wherein the nitrogen atom directly attached to the parent moleculeis substituted with one hydrogen and one group other than hydrogen, andincludes groups selected from —NH(R^(bb)), —NHC(═O)R^(aa), —NHCO₂R^(aa),—NHC(═O)N(R^(bb))₂, —NHC(═NR^(bb))N(R^(bb))₂, —NHSO₂R^(aa),—NHP(═O)(OR^(cc))₂, and —NHP(═O)(NR^(bb))₂, wherein R^(aa), R^(bb) andR^(cc) are as defined herein, and wherein R^(bb) of the group—NH(R^(bb)) is not hydrogen.

As used herein, the term “disubstituted amino” refers to an amino groupwherein the nitrogen atom directly attached to the parent molecule issubstituted with two groups other than hydrogen, and includes groupsselected from —N(R^(bb))₂, —NR^(bb)C(═O)R^(aa), —NR^(bb)CO₂R^(aa),—NR^(bb)C(═O)N(R^(bb))₂, —NR^(bb)C(═NR^(bb))N(R^(bb))₂,—NR^(bb)SO₂R^(aa), —NR^(bb)P(═O)(OR^(cc))₂, and —NR^(bb)P(═O)(NR^(bb))₂,wherein R^(aa), R^(bb), and R^(cc) are as defined herein, with theproviso that the nitrogen atom directly attached to the parent moleculeis not substituted with hydrogen.

As used herein, the term “trisubstituted amino” refers to an amino groupwherein the nitrogen atom directly attached to the parent molecule issubstituted with three groups, and includes groups selected from—N(R^(bb))₃ and —N(R^(bb))₃ ⁺X⁻, wherein R^(bb) and X⁻ are as definedherein.

Nitrogen atoms can be substituted or unsubstituted as valency permits,and include primary, secondary, tertiary, and quarternary nitrogenatoms. Exemplary nitrogen atom substitutents include, but are notlimited to, hydrogen, —OH, —OR^(aa), —N(R^(cc))₂, —CN, —C(═O)R^(aa),—C(═O)N(R^(cc))₂, —CO₂R^(aa), —SO₂R^(aa), —C(═NR^(bb))R^(aa),—C(═NR^(cc))OR^(aa), —C(═NR^(cc))N(R^(cc))₂, —SO₂N(R^(cc))₂, —SO₂R^(cc),—SO₂OR^(cc), —SOR^(aa), —C(═S)N(R^(cc))₂, —C(═O)SR^(cc), —C(═S)SR^(cc),—P(═O)₂R^(aa), —P(═O)(R^(aa))₂, —P(═O)₂N(R^(cc))₂, —P(═O)(NR^(cc))₂,C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl,heteroC₁₋₁₀alkyl, heteroC₂₋₁₀ alkenyl, heteroC₂₋₁₀ alkynyl, C₃₋₁₀carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 memberedheteroaryl, or two R^(cc) groups attached to an N atom are joined toform a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring,wherein each alkyl, alkenyl, alkynyl, heteroalkyl, heteroalkenyl,heteroalkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl isindependently substituted with 0, 1, 2, 3, 4, or 5 R^(dd) groups, andwherein R^(aa), R^(bb), R^(cc) and R^(dd) are as defined above.

In certain embodiments, the substituent present on the nitrogen atom isan nitrogen protecting group (also referred to herein as an “aminoprotecting group”). Nitrogen protecting groups include, but are notlimited to, —OH, —OR^(aa), —N(R^(cc))₂, —C(═O)R^(aa), —C(═O)N(R^(cc))₂,—CO₂R^(aa), —SO₂R^(aa), —C(═NR^(cc))R^(aa), —C(═NR^(cc))OR^(aa),—C(═NR^(cc))N(R^(cc))₂, —SO₂N(R^(cc))₂, —SO₂R^(cc), —SO₂OR^(cc),—SOR^(aa), —C(═S)N(R^(cc))₂, —C(═O)SR^(cc), —C(═S)SR^(cc), C₁₋₁₀ alkyl(e.g., aralkyl, heteroaralkyl), C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl,heteroC₁₋₁₀ alkyl, heteroC₂₋₁₀ alkenyl, heteroC₂₋₁₀ alkynyl, C₃₋₁₀carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 memberedheteroaryl groups, wherein each alkyl, alkenyl, alkynyl, heteroalkyl,heteroalkenyl, heteroalkynyl, carbocyclyl, heterocyclyl, aralkyl, aryl,and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5R^(dd) groups, and wherein R^(aa), R^(bb), R^(cc) and R^(dd) are asdefined herein. Nitrogen protecting groups are well known in the art andinclude those described in detail in Protecting Groups in OrganicSynthesis, T. W. Greene and P. G. M. Wuts, 3^(rd) edition, John Wiley &Sons, 1999, incorporated herein by reference.

For example, nitrogen protecting groups such as amide groups (e.g.,—C(═O)R^(aa)) include, but are not limited to, formamide, acetamide,chloroacetamide, trichloroacetamide, trifluoroacetamide,phenylacetamide, 3-phenylpropanamide, picolinamide,3-pyridylcarboxamide, N-benzoylphenylalanyl derivative, benzamide,p-phenylbenzamide, o-nitophenylacetamide, o-nitrophenoxyacetamide,acetoacetamide, (N′-dithiobenzyloxyacylamino)acetamide,3-(p-hydroxyphenyl)propanamide, 3-(o-nitrophenyl)propanamide,2-methyl-2-(o-nitrophenoxy)propanamide,2-methyl-2-(o-phenylazophenoxy)propanamide, 4-chlorobutanamide,3-methyl-3-nitrobutanamide, o-nitrocinnamide, N-acetylmethioninederivative, o-nitrobenzamide and o-(benzoyloxymethyl)benzamide.

Nitrogen protecting groups such as carbamate groups (e.g.,—C(═O)OR^(aa)) include, but are not limited to, methyl carbamate, ethylcarbamante, 9-fluorenylmethyl carbamate (Fmoc),9-(2-sulfo)fluorenylmethyl carbamate, 9-(2,7-dibromo)fluoroenylmethylcarbamate,2,7-di-t-butyl-[9-(10,10-dioxo-10,10,10,10-tetrahydrothioxanthyl)]methylcarbamate (DBD-Tmoc), 4-methoxyphenacyl carbamate (Phenoc),2,2,2-trichloroethyl carbamate (Troc), 2-trimethylsilylethyl carbamate(Teoc), 2-phenylethyl carbamate (hZ), 1-(1-adamantyl)-1-methylethylcarbamate (Adpoc), 1,1-dimethyl-2-haloethyl carbamate,1,1-dimethyl-2,2-dibromoethyl carbamate (DB-t-BOC),1,1-dimethyl-2,2,2-trichloroethyl carbamate (TCBOC),1-methyl-1-(4-biphenylyl)ethyl carbamate (Bpoc),1-(3,5-di-t-butylphenyl)-1-methylethyl carbamate (t-Bumeoc), 2-(2′- and4′-pyridyl)ethyl carbamate (Pyoc), 2-(N,N-dicyclohexylcarboxamido)ethylcarbamate, t-butyl carbamate (BOC), 1-adamantyl carbamate (Adoc), vinylcarbamate (Voc), allyl carbamate (Alloc), 1-isopropylallyl carbamate(Ipaoc), cinnamyl carbamate (Coc), 4-nitrocinnamyl carbamate (Noc),8-quinolyl carbamate, N-hydroxypiperidinyl carbamate, alkyldithiocarbamate, benzyl carbamate (Cbz), p-methoxybenzyl carbamate (Moz),p-nitobenzyl carbamate, p-bromobenzyl carbamate, p-chlorobenzylcarbamate, 2,4-dichlorobenzyl carbamate, 4-methylsulfinylbenzylcarbamate (Msz), 9-anthrylmethyl carbamate, diphenylmethyl carbamate,2-methylthioethyl carbamate, 2-methylsulfonylethyl carbamate,2-(p-toluenesulfonyl)ethyl carbamate, [2-(1,3-dithianyl)]methylcarbamate (Dmoc), 4-methylthiophenyl carbamate (Mtpc),2,4-dimethylthiophenyl carbamate (Bmpc), 2-phosphonioethyl carbamate(Peoc), 2-triphenylphosphonioisopropyl carbamate (Ppoc),1,1-dimethyl-2-cyanoethyl carbamate, m-chloro-p-acyloxybenzyl carbamate,p-(dihydroxyboryl)benzyl carbamate, 5-benzisoxazolylmethyl carbamate,2-(trifluoromethyl)-6-chromonylmethyl carbamate (Tcroc), m-nitrophenylcarbamate, 3,5-dimethoxybenzyl carbamate, o-nitrobenzyl carbamate,3,4-dimethoxy-6-nitrobenzyl carbamate, phenyl(o-nitrophenyl)methylcarbamate, t-amyl carbamate, S-benzyl thiocarbamate, p-cyanobenzylcarbamate, cyclobutyl carbamate, cyclohexyl carbamate, cyclopentylcarbamate, cyclopropylmethyl carbamate, p-decyloxybenzyl carbamate,2,2-dimethoxyacylvinyl carbamate, o-(N,N-dimethylcarboxamido)benzylcarbamate, 1,1-dimethyl-3-(N,N-dimethylcarboxamido)propyl carbamate,1,1-dimethylpropynyl carbamate, di(2-pyridyl)methyl carbamate,2-furanylmethyl carbamate, 2-iodoethyl carbamate, isoborynl carbamate,isobutyl carbamate, isonicotinyl carbamate,p-(p′-methoxyphenylazo)benzyl carbamate, 1-methylcyclobutyl carbamate,1-methylcyclohexyl carbamate, 1-methyl-1-cyclopropylmethyl carbamate,1-methyl-1-(3,5-dimethoxyphenyl)ethyl carbamate,1-methyl-1-(p-phenylazophenyl)ethyl carbamate, 1-methyl-1-phenylethylcarbamate, 1-methyl-1-(4-pyridyl)ethyl carbamate, phenyl carbamate,p-(phenylazo)benzyl carbamate, 2,4,6-tri-t-butylphenyl carbamate,4-(trimethylammonium)benzyl carbamate, and 2,4,6-trimethylbenzylcarbamate.

Nitrogen protecting groups such as sulfonamide groups (e.g.,—S(═O)₂R^(aa)) include, but are not limited to, p-toluenesulfonamide(Ts), benzenesulfonamide, 2,3,6,-trimethyl-4-methoxybenzenesulfonamide(Mtr), 2,4,6-trimethoxybenzenesulfonamide (Mtb),2,6-dimethyl-4-methoxybenzenesulfonamide (Pme),2,3,5,6-tetramethyl-4-methoxybenzenesulfonamide (Mte),4-methoxybenzenesulfonamide (Mbs), 2,4,6-trimethylbenzenesulfonamide(Mts), 2,6-dimethoxy-4-methylbenzenesulfonamide (iMds),2,2,5,7,8-pentamethylchroman-6-sulfonamide (Pmc), methanesulfonamide(Ms), β-trimethylsilylethanesulfonamide (SES), 9-anthracenesulfonamide,4-(4′,8′-dimethoxynaphthylmethyl)benzenesulfonamide (DNMBS),benzylsulfonamide, trifluoromethylsulfonamide, and phenacylsulfonamide.

Other nitrogen protecting groups include, but are not limited to,phenothiazinyl-(10)-acyl derivative, N′-p-toluenesulfonylaminoacylderivative, N′-phenylaminothioacyl derivative, N-benzoylphenylalanylderivative, N-acetylmethionine derivative,4,5-diphenyl-3-oxazolin-2-one, N-phthalimide, N-dithiasuccinimide (Dts),N-2,3-diphenylmaleimide, N-2,5-dimethylpyrrole,N-1,1,4,4-tetramethyldisilylazacyclopentane adduct (STABASE),5-substituted 1,3-dimethyl-1,3,5-triazacyclohexan-2-one, 5-substituted1,3-dibenzyl-1,3,5-triazacyclohexan-2-one, 1-substituted3,5-dinitro-4-pyridone, N-methylamine, N-allylamine,N-[2-(trimethylsilyl)ethoxy]methylamine (SEM), N-3-acetoxypropylamine,N-(1-isopropyl-4-nitro-2-oxo-3-pyroolin-3-yl)amine, quaternary ammoniumsalts, N-benzylamine, N-di(4-methoxyphenyl)methylamine,N-5-dibenzosuberylamine, N-triphenylmethylamine (Tr),N-[(4-methoxyphenyl)diphenylmethyl]amine (MMTr),N-9-phenylfluorenylamine (PhF),N-2,7-dichloro-9-fluorenylmethyleneamine, N-ferrocenylmethylamino (Fcm),N-2-picolylamino N′-oxide, N-1,1-dimethylthiomethyleneamine,N-benzylideneamine, N-p-methoxybenzylideneamine,N-diphenylmethyleneamine, N-[(2-pyridyl)mesityl]methyleneamine,N—(N′,N′-dimethylaminomethylene)amine, N,N′-isopropylidenediamine,N-p-nitrobenzylideneamine, N-salicylideneamine,N-5-chlorosalicylideneamine,N-(5-chloro-2-hydroxyphenyl)phenylmethyleneamine,N-cyclohexylideneamine, N-(5,5-dimethyl-3-oxo-1-cyclohexenyl)amine,N-borane derivative, N-diphenylborinic acid derivative,N-[phenyl(pentaacylchromium- or tungsten)acyl]amine, N-copper chelate,N-zinc chelate, N-nitroamine, N-nitrosoamine, amine N-oxide,diphenylphosphinamide (Dpp), dimethylthiophosphinamide (Mpt),diphenylthiophosphinamide (Ppt), dialkyl phosphoramidates, dibenzylphosphoramidate, diphenyl phosphoramidate, benzenesulfenamide,o-nitrobenzenesulfenamide (Nps), 2,4-dinitrobenzenesulfenamide,pentachlorobenzenesulfenamide, 2-nitro-4-methoxybenzenesulfenamide,triphenylmethylsulfenamide, and 3-nitropyridinesulfenamide (Npys).

In certain embodiments, the substituent present on an oxygen atom is anoxygen protecting group (also referred to herein as an “hydroxylprotecting group”). Oxygen protecting groups include, but are notlimited to, —R^(aa), —N(R^(bb))₂, —C(═O)SR^(aa), —C(═O)R^(aa),—CO₂R^(aa), —C(═O)N(R^(bb))₂, —C(═NR^(bb))R^(aa), —C(═NR^(bb))OR^(aa),—C(═NR^(bb))N(R^(bb))₂, —S(═O)R^(aa), —SO₂R^(aa), —Si(R^(aa))₃,—P(R^(cc))₂, —P(R^(cc))₃, —P(═O)₂R^(aa), —P(═O)(R^(aa))₂,—P(═O)(OR^(cc))₂, —P(═O)₂N(R^(bb))₂, and —P(═O)(NR^(bb))₂, whereinR^(aa), R^(bb), and R^(cc) are as defined herein. Oxygen protectinggroups are well known in the art and include those described in detailin Protecting Groups in Organic Synthesis, T. W. Greene and P. G. M.Wuts, 3^(rd) edition, John Wiley & Sons, 1999, incorporated herein byreference.

Exemplary oxygen protecting groups include, but are not limited to,methyl, methoxylmethyl (MOM), methylthiomethyl (MTM), t-butylthiomethyl,(phenyldimethylsilyl)methoxymethyl (SMOM), benzyloxymethyl (BOM),p-methoxybenzyloxymethyl (PMBM), (4-methoxyphenoxy)methyl (p-AOM),guaiacolmethyl (GUM), t-butoxymethyl, 4-pentenyloxymethyl (POM),siloxymethyl, 2-methoxyethoxymethyl (MEM), 2,2,2-trichloroethoxymethyl,bis(2-chloroethoxy)methyl, 2-(trimethylsilyl)ethoxymethyl (SEMOR),tetrahydropyranyl (THP), 3-bromotetrahydropyranyl,tetrahydrothiopyranyl, 1-methoxycyclohexyl, 4-methoxytetrahydropyranyl(MTHP), 4-methoxytetrahydrothiopyranyl, 4-methoxytetrahydrothiopyranylS,S-dioxide, 1-[(2-chloro-4-methyl)phenyl]-4-methoxypiperidin-4-yl(CTMP), 1,4-dioxan-2-yl, tetrahydrofuranyl, tetrahydrothiofuranyl,2,3,3a,4,5,6,7,7a-octahydro-7,8,8-trimethyl-4,7-methanobenzofuran-2-yl,1-ethoxyethyl, 1-(2-chloroethoxy)ethyl, 1-methyl-1-methoxyethyl,1-methyl-1-benzyloxyethyl, 1-methyl-1-benzyloxy-2-fluoroethyl,2,2,2-trichloroethyl, 2-trimethylsilylethyl, 2-(phenylselenyl)ethyl,t-butyl, allyl, p-chlorophenyl, p-methoxyphenyl, 2,4-dinitrophenyl,benzyl (Bn), p-methoxybenzyl, 3,4-dimethoxybenzyl, o-nitrobenzyl,p-nitrobenzyl, p-halobenzyl, 2,6-dichlorobenzyl, p-cyanobenzyl,p-phenylbenzyl, 2-picolyl, 4-picolyl, 3-methyl-2-picolyl N-oxido,diphenylmethyl, p,p′-dinitrobenzhydryl, 5-dibenzosuberyl,triphenylmethyl, α-naphthyldiphenylmethyl,p-methoxyphenyldiphenylmethyl, di(p-methoxyphenyl)phenylmethyl,tri(p-methoxyphenyl)methyl, 4-(4′-bromophenacyloxyphenyl)diphenylmethyl,4,4′,4″-tris(4,5-dichlorophthalimidophenyl)methyl,4,4′,4″-tris(levulinoyloxyphenyl)methyl,4,4′,4″-tris(benzoyloxyphenyl)methyl,3-(imidazol-1-yl)bis(4′,4″-dimethoxyphenyl)methyl,1,1-bis(4-methoxyphenyl)-1′-pyrenylmethyl, 9-anthryl,9-(9-phenyl)xanthenyl, 9-(9-phenyl-10-oxo)anthryl,1,3-benzodithiolan-2-yl, benzisothiazolyl S,S-dioxido, trimethylsilyl(TMS), triethylsilyl (TES), triisopropylsilyl (TIPS),dimethylisopropylsilyl (IPDMS), diethylisopropylsilyl (DEIPS),dimethylthexylsilyl, t-butyldimethylsilyl (TBDMS), t-butyldiphenylsilyl(TBDPS), tribenzylsilyl, tri-p-xylylsilyl, triphenylsilyl,diphenylmethylsilyl (DPMS), t-butylmethoxyphenylsilyl (TBMPS), formate,benzoylformate, acetate, chloroacetate, dichloroacetate,trichloroacetate, trifluoroacetate, methoxyacetate,triphenylmethoxyacetate, phenoxyacetate, p-chlorophenoxyacetate,3-phenylpropionate, 4-oxopentanoate (levulinate),4,4-(ethylenedithio)pentanoate (levulinoyldithioacetal), pivaloate,adamantoate, crotonate, 4-methoxycrotonate, benzoate, p-phenylbenzoate,2,4,6-trimethylbenzoate (mesitoate), alkyl methyl carbonate,9-fluorenylmethyl carbonate (Fmoc), alkyl ethyl carbonate, alkyl2,2,2-trichloroethyl carbonate (Troc), 2-(trimethylsilyl)ethyl carbonate(TMSEC), 2-(phenylsulfonyl)ethyl carbonate (Psec),2-(triphenylphosphonio) ethyl carbonate (Peoc), alkyl isobutylcarbonate, alkyl vinyl carbonate alkyl allyl carbonate, alkylp-nitrophenyl carbonate, alkyl benzyl carbonate, alkyl p-methoxybenzylcarbonate, alkyl 3,4-dimethoxybenzyl carbonate, alkyl o-nitrobenzylcarbonate, alkyl p-nitrobenzyl carbonate, alkyl S-benzyl thiocarbonate,4-ethoxy-1-napththyl carbonate, methyl dithiocarbonate, 2-iodobenzoate,4-azidobutyrate, 4-nitro-4-methylpentanoate, o-(dibromomethyl)benzoate,2-formylbenzenesulfonate, 2-(methylthiomethoxy)ethyl,4-(methylthiomethoxy)butyrate, 2-(methylthiomethoxymethyl)benzoate,2,6-dichloro-4-methylphenoxyacetate,2,6-dichloro-4-(1,1,3,3-tetramethylbutyl)phenoxyacetate,2,4-bis(1,1-dimethylpropyl)phenoxyacetate, chlorodiphenylacetate,isobutyrate, monosuccinoate, (E)-2-methyl-2-butenoate,o-(methoxyacyl)benzoate, α-naphthoate, nitrate, alkylN,N,N′,N′-tetramethylphosphorodiamidate, alkyl N-phenylcarbamate,borate, dimethylphosphinothioyl, alkyl 2,4-dinitrophenylsulfenate,sulfate, methanesulfonate (mesylate), benzylsulfonate, and tosylate(Ts).

In certain embodiments, the substituent present on an sulfur atom is asulfur protecting group (also referred to as a “thiol protectinggroup”). Sulfur protecting groups include, but are not limited to,—R^(aa), —N(R^(bb))₂, —C(═O)SR^(aa), —C(═O)R^(aa), —CO₂R^(aa),—C(═O)N(R^(bb))₂, —C(═NR^(bb))R^(aa), —C(═NR^(bb))OR^(aa),—C(═NR^(bb))N(R^(bb))₂, —S(═O)R^(aa), —SO₂R^(aa), Si(R^(aa))₃,—P(R^(cc))₂, —P(R^(cc))₃, —P(═O)₂R^(aa), —P(═O)(R^(aa))₂,—P(═O)(OR^(cc))₂, —P(═O)₂N(R^(bb))₂, and —P(═O)(NR^(bb))₂, whereinR^(aa), R^(bb), and R^(cc) are as defined herein. Sulfur protectinggroups are well known in the art and include those described in detailin Protecting Groups in Organic Synthesis, T. W. Greene and P. G. M.Wuts, 3^(rd) edition, John Wiley & Sons, 1999, incorporated herein byreference.

These and other exemplary substituents are described in more detail inthe Detailed Description, Examples, and claims. The invention is notintended to be limited in any manner by the above exemplary listing ofsubstituents.

OTHER DEFINITIONS

The term “pharmaceutically acceptable salt” refers to those salts whichare, within the scope of sound medical judgment, suitable for use incontact with the tissues of humans and lower animals without unduetoxicity, irritation, allergic response and the like, and arecommensurate with a reasonable benefit/risk ratio. Pharmaceuticallyacceptable salts are well known in the art. For example, Berge et al.,describes pharmaceutically acceptable salts in detail in J.Pharmaceutical Sciences (1977) 66:1-19. Pharmaceutically acceptablesalts of the compounds of this invention include those derived fromsuitable inorganic and organic acids and bases. Examples ofpharmaceutically acceptable, nontoxic acid addition salts are salts ofan amino group formed with inorganic acids such as hydrochloric acid,hydrobromic acid, phosphoric acid, sulfuric acid and perchloric acid orwith organic acids such as acetic acid, oxalic acid, maleic acid,tartaric acid, citric acid, succinic acid or malonic acid or by usingother methods used in the art such as ion exchange. Otherpharmaceutically acceptable salts include adipate, alginate, ascorbate,aspartate, benzenesulfonate, benzoate, bisulfate, borate, butyrate,camphorate, camphorsulfonate, citrate, cyclopentanepropionate,digluconate, dodecylsulfate, ethanesulfonate, formate, fumarate,glucoheptonate, glycerophosphate, gluconate, hemisulfate, heptanoate,hexanoate, hydroiodide, 2-hydroxy-ethanesulfonate, lactobionate,lactate, laurate, lauryl sulfate, malate, maleate, malonate,methanesulfonate, 2-naphthalenesulfonate, nicotinate, nitrate, oleate,oxalate, palmitate, pamoate, pectinate, persulfate, 3-phenylpropionate,phosphate, picrate, pivalate, propionate, stearate, succinate, sulfate,tartrate, thiocyanate, p-toluenesulfonate, undecanoate, valerate salts,and the like. Pharmaceutically acceptable salts derived from appropriatebases include alkali metal, alkaline earth metal, ammonium andN⁺(C₁₋₄alkyl)₄ salts. Representative alkali or alkaline earth metalsalts include sodium, lithium, potassium, calcium, magnesium, and thelike. Further pharmaceutically acceptable salts include, whenappropriate, nontoxic ammonium, quaternary ammonium, and amine cationsformed using counterions such as halide, hydroxide, carboxylate,sulfate, phosphate, nitrate, lower alkyl sulfonate, and aryl sulfonate.

“Disease”, “disorder,” and “condition” are used interchangeably herein.

As used herein, an “individual” or “subject” to which administration iscontemplated includes, but is not limited to, humans (i.e., a male orfemale of any age group, e.g., a pediatric subject (e.g., child,adolescent) or adult subject (e.g., young adult, middle-aged adult orsenior adult)), other primates (e.g., cynomolgus monkeys, rhesusmonkeys) and commercially relevant mammals such as cattle, pigs (e.g.,livestock, minipigs), horses, sheep, goats, cats, and/or dogs. In anyaspect and/or embodiment of the invention, the mammal can be a human.

As used herein, “local administration” or “administering locally” or“local effect” means administration/application of the active ingredientor active metabolite thereof directly, or in proximity to, a part of thebody, tissue, or lesion where said active substance is intended to exertits action. This may include, for example, topical administration toskin or injection at the part of the body where an increase of fat isneeded.

As used herein, “percutaneous” or “percutaneous administration” or“percutaneous delivery” or “percutaneously administering” or“percutaneously delivering” means administration to or through the skinthat results in a local effect on subcutaneous fat without acorresponding, clinically significant systemic effect. With superficialskin delivery, the drug remains on or within the skin. With transdermaldelivery, system exposure to the drug is sufficient to result in aclinically significant systemic effect. In contrast, with percutaneousdelivery, the drug passes into the subcutaneous fat, but systemicexposure is negligible, e.g., it does not cause a clinically significantsystemic effect. See, e.g., FIG. 1.

As used herein, “systemic” refers to an action or effect that occurs inone or more part(s) of the body other than that part of the body where adrug is administered or intended to exert its action.

A “corresponding systemic effect” is manifested, for example, when thedrug's local effect at the site of administration is also seen at a siteon the body that is distant from the site of administration. Forexample, administration of a drug to one side (e.g., flank) of the bodyresulting in a increased fat on both sides of the body would indicate asystemic effect. Conversely, with percutaneous administration,subcutaneous fat at the treatment site is increased with respect tosubcutaneous fat on a control site.

As used herein, a “clinically significant systemic effect” means asystemic effect that is large enough to affect a patient's health,disease state, or risk of disease in a manner that is noticeable to thepatient and/or caregiver. See, e.g., Jonas et al. Drug Class Review:Newer diabetes medications, TZDs, and combinations. Final OriginalReport. Drug Effectiveness Review Project, February 2011. The effect canbe immediate or delayed; for example, a patient with abnormally elevatedserum glucose concentrations (diabetes) may not immediately notice thediabetes, but the diabetes eventually noticeably affects the patient'shealth, for example, by renal impairment, heart disease, and visionloss. As a further example, assume that a patient with diabetes has ahemoglobin A1C value (a long-term marker of glucose control) that iselevated at 8.00%. An effect that changes the hemoglobin A1C value to7.99 or 8.01 would not be clinically significant, because it would notaffect the occurrence or risk of renal impairment, heart disease, orvision loss. However, an effect that changes the hemoglobin A1C value to7.00 or 9.00 would be clinically significant, insofar as it would affectthe occurrence or risk of the aforementioned outcomes.

As used herein, a “percutaneous carrier” or “percutaneous excipient”means a carrier that, when combined with one or more active ingredientsand administered to the subject, results in a local effect onsubcutaneous fat without a clinically significant systemic effect.

As used herein, a “treatment site” is the place on the body where thedrug is administered.

As used herein, a “control site” is a place on a body suitable for useas a control in a controlled experiment. The control site can be a placeon the body that is comparable to the treatment site (e.g.,contralateral) but is untreated or treated with a placebo (e.g.,inactive vehicle). The control site and the treatment site can be on thesame subject or on different subjects.

As used herein, unless otherwise defined by the context, “anhydrous”refers to a composition that is lacking or essentially lacking in water,e.g., for example, if no water is added to the composition, and/or ifwater is removed from the composition. For example, in certainembodiments, an anhydrous composition may consist of between about 0 andabout 1 percent of water by weight, e.g., about 0%, about 0.1%, about0.2%, about 0.3%, about 0.4%, about 0.5%, about 0.6%, about 0.7%, about0.8%, about 0.9%, or about 1% of water by weight.

As used herein, and unless otherwise specified, a “therapeuticallyeffective amount” “an amount sufficient” or “sufficient amount” of acompound means the level, amount or concentration of the compound neededto treat a disease, disorder or condition, or to improve a particularparameter (e.g., increase body fat, reduce wrinkles) in the body of asubject, without causing significant negative or adverse side effects tobody or the treated tissue. The term “therapeutically effective amount”can encompass an amount that improves overall therapy, reduces or avoidssymptoms or causes of disease or condition, or enhances the therapeuticefficacy of another therapeutically active agent.

As used herein, the terms “increase”, “increasing”, “raise”, or“raising” means to increase or raise the volume, size, mass, bulk,density, amount, and/or quantity of a substance (e.g., body fat, adiposetissue) in the body of a subject.

As used herein, the terms “augment,” “augmenting,” and “augmentation”refer to increasing the size or prominence of a body part or particulararea thereof. The size can be measured by any suitable measure (e.g.,linear, circumferential, volumetric, mass). Suitable measures of sizeare envisioned to include, without limitation, histology (e.g., biopsy,necropsy) or non-invasive measures of subcutaneous fat depth (e.g., skinfold calipers, magnetic resonance imaging, computed tomography,dual-energy x-ray absorptiometry, ultrasound, and the like). Size isfurther envisioned, without limitation, to include external measurementof any human body part (e.g., a tailor's measurements, e.g., of theneck, chest, limbs, waist, hips) and sizing schemes used for articles ofclothing and the like. Prominence can be anatomic or visual, absolute ormeasured with respect to another body part, and measured by any suitableobjective or subjective variable, including a subjective rating scale.

As used herein, “suffer”, “suffers” or “suffering from” refers to asubject diagnosed with a particular disease or condition. As usedherein, “likely to suffer” refers to a subject who has not beendiagnosed with a particular disease or condition by a medicalpractitioner, but has a predisposition (e.g., genetic and/or physiologicpredisposition), or exhibits signs or symptoms of the disease orcondition.

As used herein, and unless otherwise specified, the terms “treat,”“treating” and “treatment” contemplate an action that occurs while asubject is suffering from the specified disease or condition, whichreduces the severity of the disease or condition, or retards or slowsthe progression of the disease or condition.

As used herein, unless otherwise specified, the terms “prevent,”“preventing” and “prevention” contemplate an action that occurs before asubject begins to suffer from the specified disease or condition, whichinhibits or reduces the severity of the disease or condition.

As used herein, and unless otherwise specified, the term “medicament”means a substance administered to an individual to treat or prevent adisease or condition. Unless otherwise clear from the context, the terms“medicament,” “medication,” “medicine,” and “pharmaceutical composition”are used interchangeably.

As used herein, the term “prodrug” means a compound that can hydrolyze,oxidize, or otherwise react under biological conditions (e.g., in vitroor in vivo enzymatic conditions) to provide a pharmacologically activecompound. In certain cases, a prodrug has improved physical and/ordelivery properties over the parent compound. Prodrugs are typicallydesigned to enhance pharmacologically, pharmaceutically and/orpharmacokinetically based properties associated with the parentcompound. The advantage of a prodrug can lie in its physical properties,such as enhanced solubility for formulation compared to the parentcompound, or enhanced penetration across the stratum corneum of theskin, or enhanced deposition in the subcutaneous fat.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A-1C depicts a schematic diagram of superficial skin delivery(FIG. 1A), transdermal delivery into the bloodstream (FIG. 1B), andpercutaneous delivery into fat (FIG. 1C). The relative presence orconcentration of a drug is indicated by the letter “D.” Note that withsuperficial skin delivery (FIG. 1A), the drug remains on or within theskin. With transdermal delivery (FIG. 1B), substantial amounts of thedrug are absorbed in the dermal circulation and into the bloodstream,thus leading to systemic effects. With percutaneous delivery (FIG. 1C),drug passes into the subcutaneous fat, with negligible presence in thebloodstream.

FIG. 2 is a photograph of a representative mouse following 24 days oftreatment with percutaneous megestrol, as further described inExample 1. The photograph is oriented such that the left flank of theanimal is shown at left. Skin folds on the left (untreated) and right(treated) flanks are compared, with the approximate thickness indicatedby a yellow line. Thickness of the skin fold at left was about 2 mm,whereas the skin fold at right was about 4 mm.

FIG. 3 shows photomicrographs of hematoxylin- and eosin-stained axialsections of tissue from the left and right flanks shown in FIG. 2.Subcutaneous fat was thicker on the right (treated) flank (right panel)compared to the left (untreated) flank (left panel). Both panels shownat same magnification.

FIG. 4 shows photomicrographs of hematoxylin- and eosin-stained axialsections of tissue from the right flanks of representative mice treatedwith vehicle (left panel) or percutaneous rosiglitazone (right panel).Compared to mice treated with vehicle (left panel), subcutaneous fat wasthicker on the flanks of animals treated with rosiglitazone (rightpanel). Both panels shown at same magnification.

FIG. 5 shows representative low-power views of hematoxylin- andeosin-stained axial sections of tissue from the right and left flanks ofminipigs treated with percutaneous rosiglitazone (slides marked “T”) orvehicle (slides marked “C”). Slides pairs are from anatomic sites thatare precisely contralateral to one another. See Example 4 for furtherdetails. All panels shown at same magnification.

DETAILED DESCRIPTION OF CERTAIN EMBODIMENTS OF THE INVENTION

The present invention arises from the realization that percutaneouslyadministering a thiazolidinedione or an orexigenic compound to a subjecteffectively achieves a local increase in subcutaneous fat. This findingarose during an in vivo study in lean mice (Example 1), and was thencorroborated and improved in further mouse and minipig studies (e.g.,Examples 2 and 4) as well as in vitro studies of human skin (e.g.,Example 5).

The first mouse study involved a control arm and four intervention arms,each with a different class of compound that when administeredsystemically to humans is known to promote obesity and fat accumulation.

The arms were as follows: vehicle (Lipoderm®), a thiazolidinedione(pioglitazone), harmine, an orexigenic compound (megestrol acetate), andefavirenz. Each compound was combined in the percutaneous Lipoderm®formulation at an equimolar concentration (5 mM). The Lipoderm® vehicleis adapted to deliver the respective compound percutaneously, i.e.,across the skin and into subcutaneous fat. The formulations were applieddaily to the right flank of each animal, whereas the left flank was usedas an untreated control.

Following 24 days of therapy, animals treated with a thiazolidinedione(pioglitazone) or an orexigenic compound (megestrol acetate) exhibitedlocal increases in subcutaneous fat (right flanks only). However,animals treated with vehicle, harmine, or efavirenz did not exhibit anyincrease in fat or asymmetry between the two flanks. The asymmetricincreases in body fat seen in animals treated with pioglitazone andmegestrol acetate were corroborated by modest increases in overallweight gain, as compared to animals in other groups.

The superiority of pioglitazone for increasing local fat in this studywas unexpected, not least because harmine, another class of PPARγactivator with similar biophysical and pharmacokinetic properties, hadno effect. Furthermore, although it had been hypothesized based solelyon in vitro evidence that topical administration of a thiazolidinedioneto an individual could locally increase body fat, no such effect hasbeen observed in a clinical trial of a topically appliedthiazolidinedione. See, e.g., Kuenzli and Saurat, Dermatology (2003)206:252-256.

The superiority of megestrol acetate for increasing local fat in thisstudy was also unexpected, because this compound's obesity-promotingaction is believed to be due to appetite stimulation (which would havemanifested as diffuse rather than local increases in fat in theaforementioned mouse study). Furthermore, subcutaneous implantationand/or transdermal administration of megestrol acetate has not beenassociated with fat accumulation at the site of administration, a sideeffect which almost certainly would have attracted the notice ofclinical investigators, treating physicians, and patients. See, e.g.,Coutinho, et al., Contraception (1996) 53:121-125.

The present invention also arises from the reduction to practice of ameans for administering a thiazolidinedione or an orexigenic compoundsuch that a therapeutic effect is achieved in local subcutaneous fat,without a systemic effect (which would have manifested as diffuse ratherthan local increases in fat in the aforementioned mouse study). Thispercutaneous mode of delivery is to be distinguished from superficialapplication to the skin, whereby deep penetration does not occur. See,e.g., FIG. 1. Percutaneous administration is also to be distinguishedfrom transdermal administration, where the objective is absorption intothe bloodstream to achieve a systemic effect. Transdermal administrationof a thiazolidinedione, e.g., rosiglitazone, to the skin can result inclinically significant drug delivery to the bloodstream. See, e.g.,Damodharan et al, Skin permeation of rosiglitazone from transdermalmatrix patches, Pharmaceutical Technology (2010) 34:56-72. See also,e.g., Ghosh et al, Feasibility of rosiglitazone maleate for transdermaldelivery, Int. J. Pharm. Res. Innov. (2011) 2:23-31. Transdermaladministration of thiazolidinediones is considered undesirable andpotentially unsafe and would undermine the purpose of the invention,e.g., by causing obesity. Transdermal administration of megestrol wouldbe expected to cause obesity and act as a contraceptive, which for thepresent invention would be undesirable.

While superficial and transdermal administration are commonpharmaceutical routes of administration, very few examples ofpercutaneous administration to subcutaneous fat are known for anycompound. See, e.g., Singh et al., Local deep tissue penetration ofcompounds after dermal application: structure-tissue penetrationrelationships. JPET (1996) 279:908-917.

According to the present invention, thiazolidinediones and/or anorexigenic compounds, as described herein, are to be administeredpercutaneously (e.g., in a percutaneous formulation to the skin, or byinjection through the skin) in order to achieve a local increase insubcutaneous body fat. The percutaneous administration confers twocrucial advantages: the ability to limit therapy to a particularaffected part of the body, and the ability to avoid systemic exposure(and therefore systemic risks and side effects).

Percutaneous administration can be directed to particular affected areasof the body of the subject, e.g., for example, the head (e.g., the facesuch as the forehead, forehead, periorbital region, cheeks, chin, lips,and other anterior structures from top of forehead to bottom of chin),breast, limbs, hands, trunk, hips, and buttocks. Without being bound bytheory, increase in fat as a function of administration of athiazolidinedione or an orexigenic compound as disclosed herein mayinclude increasing the number of fat cells, increasing the volume of oneor more fat cells, increasing maturation of one or more fat cells,and/or promoting differentiation of one or more fat cells.

Increasing fat can include increasing fat as measured by at least one ofvolume, size, mass, bulk, density, amount, and/or quantity. The presentinvention is expected to increase fat by greater than or equal to 75%,greater than or equal to 70%, greater than or equal to 60%, greater thanor equal to 50%, greater than or equal to 40%, greater than or equal to30%, greater than or equal to 25%, greater than or equal to 20%, greaterthan or equal to 15%, greater than or equal to 10%, or greater than orequal to 5%. For example, increasing fat can also include increasing fatcell amount (for example, fat cell number), increasing fat cell volume,increasing fat cell maturation, and/or promoting fat celldifferentiation.

Thiazolidinedione Compounds

Thiazolidinediones are a class of medications previously approved forsystemic administration for the treatment of type 2 diabetes mellitus.Thiazolidinediones specifically contemplated for use include, but arenot limited to, rosiglitazone, pioglitazone, troglitazone, ciglitazone,netoglitazone, rivoglitazone, and pharmaceutically acceptable salts andprodrugs thereof.

Rosiglitazone, pioglitazone, and troglitazone were previously marketedfor diabetes. However, these compounds have been withdrawn or restrictedin most countries, and development of other thiazolidinediones has beenabandoned, due to safety concerns, e.g., death, cardiovascular adverseevents, bladder cancer, hepatitis, and bone fractures. Accordingly,health care practitioners and scientists have been strongly dissuadedfrom further use or development of thiazolidinediones. A known adverseeffect of systemically administered thiazolidinediones is obesity andaccumulation of body fat. See, e.g., Smith et al, Metabolism (2005)54:24-32; Jacob et al, Diabetes Obes Metab (2007) 9:386-393; Kim et al,Eur J Endocrinol (2007) 157:167-174. This effect is widely attributed tothe molecular action of these compounds, which is activation ofPeroxisome Proliferator-Activated Receptor Gamma (PPARγ). The undesiredtendency of systemic thiazolidinedione administration to promote obesityhas nevertheless been exploited to increase body fat in individualsaffected by lipodystrophy, e.g., HIV lipodystrophy. See, e.g., Slama etal, Antivir Ther (2008)13:67-76. Drawbacks of this systemic approachinclude the potential for serious side effects, e.g., cardiovascularadverse events, bladder cancer, and hepatitis, and the inability todirect therapy to a particular part of the body. Thus, systemicthiazolidinedione administration is viewed as impractical for thepromotion of obesity, and a safer means is needed to achieve a localincrease in body fat.

In contrast, the present invention contemplates percutaneousadministration of thiazolidinediones for locally increasing body fat.For example, in one aspect, provided is a method for increasing fatlocally in a subject in need thereof, the method comprisingadministering percutaneously to the subcutaneous fat of the subject athiazolidinedione or pharmaceutically acceptable salt or prodrugthereof. In certain embodiments, the administering step comprisestopical application to the skin using a percutaneous carrier, or byintradermal injection, subcutaneous injection, intramuscular injection,intralesional injection, transmucosal injection, or mucosal application.

In certain embodiments, the thiazolidinedione is a compound of Formula(I):

or a pharmaceutically acceptable salt or prodrug thereof;wherein:

Ring A is substituted or unsubstituted arylene or substituted orunsubstituted heteroarylene;

L is substituted or unsubstituted C₁₋₆alkylene or substituted orunsubstituted heteroC₁₋₆alkylene; and

Ring B is substituted or unsubstituted carbocyclyl, substituted orunsubstituted heterocyclyl, substituted or unsubstituted aryl, orsubstituted or unsubstituted heteroaryl.

In certain embodiments, Ring A is substituted or unsubstituted arylene,e.g., substituted or unsubstituted phenylene or substituted orunsubstituted naphthylene. In certain embodiments, Ring A is substitutedor unsubstituted phenylene.

In certain embodiments, Ring A is substituted or unsubstitutedheteroarylene, e.g., a 6-membered heteroarylene such as substituted orunsubstituted pyridinylene.

In certain embodiments, L is substituted or unsubstituted C₁₋₆alkylene,e.g., substituted or unsubstituted C₁alkylene, substituted orunsubstituted C₂alkylene, substituted or unsubstituted C₃alkylene,substituted or unsubstituted C₄alkylene, substituted or unsubstitutedC₅alkylene, or substituted or unsubstituted C₆alkylene. In certainembodiments, L is —CH₂—, —(CH₂)₂—, —(CH₂)₃—, —(CH₂)₄—, —(CH₂)₅—, or—(CH₂)₆—.

In certain embodiments, L is substituted or unsubstitutedheteroC₁₋₆alkylene, e.g., substituted or unsubstituted heteroC₁alkylene,substituted or unsubstituted heteroC₂alkylene, substituted orunsubstituted heteroC₃alkylene, substituted or unsubstitutedheteroC₄alkylene, substituted or unsubstituted heteroC₅alkylene, orsubstituted or unsubstituted heteroC₆alkylene. In certain embodiments, Lis —CH₂(Y)—, —(CH₂)₂(Y)—, —(CH₂)₃(Y)—, —(CH₂)₄(Y)—, —(CH₂)₅(Y)—, or—(CH₂)₆(Y)—, wherein Y is O, S, or NR^(L), and R^(L) is hydrogen, anitrogen protecting group, or C₁₋₆alkyl (e.g., methyl). In certainembodiments, Y is NR^(L), and R^(L) is hydrogen or methyl.

In certain embodiments, Ring B is substituted or unsubstitutedcarbocyclyl, e.g., substituted or unsubstituted C₅₋₆ carbocyclyl. Incertain embodiments, Ring B is substituted or unsubstituted cyclopentyl.In certain embodiments, Ring B is substituted or unsubstitutedcyclohexyl.

In certain embodiments, Ring B is substituted or unsubstitutedheterocyclyl, e.g., a 5- to 6-membered heterocyclyl. In certainembodiments, the heterocyclyl ring comprises a substituted orunsubstituted aryl or substituted or unsubstituted heteroaryl ring fusedthereto, wherein the point of attachment is on the heterocyclyl ring. Incertain embodiments, Ring B is a 6-membered substituted or unsubstitutedheterocyclyl, e.g., a substituted or unsubstituted dihydropyranylcomprising a substituted or unsubstituted aryl ring fused thereto, alsoreferred to as substituted or unsubstituted chromanyl.

In certain embodiments, Ring B is substituted or unsubstituted aryl,e.g., substituted or unsubstituted phenyl or substituted orunsubstituted naphthyl. In certain embodiments, Ring B is substituted orunsubstituted phenyl.

In certain embodiments, Ring B is substituted or unsubstitutedheteroaryl. In certain embodiments, Ring B is a substituted orunsubstituted 6-membered heteroaryl, e.g., substituted or unsubstitutedpyridinyl. In certain embodiments, Ring B is a substituted orunsubstituted bicyclic heteroaryl, e.g., a substituted or unsubstituted5,6-bicyclic heteroaryl, e.g., substituted or unsubstitutedbenzimidazolyl.

Various combinations of the above embodiments are contemplated herein.

For example, in certain embodiments, wherein Ring A is phenylene,provided is a compound of Formula (I-a):

or a pharmaceutically acceptable salt or prodrug thereof. In certainembodiments, L is —CH₂(Y)— or —(CH₂)₂(Y)—, wherein Y is O, S, or NR^(L).In certain embodiments, L is —CH₂—, —(CH₂)₂—, or —(CH₂)₃—. In certainembodiments, Ring B is substituted or unsubstituted cyclohexyl. Incertain embodiments, Ring B is a substituted or unsubstituted chromanyl.In certain embodiments, Ring B is substituted or unsubstituted phenyl.In certain embodiments, Ring B is substituted or unsubstitutedheteroaryl, e.g., substituted or unsubstituted pyridinyl or substitutedor unsubstituted benzimidazolyl.

In certain embodiments, wherein Ring A is naphthylene, provided is acompound of Formula (I-b):

or a pharmaceutically acceptable salt or prodrug thereof. In certainembodiments, L is —CH₂(Y)— or —(CH₂)₂(Y)—, wherein Y is O, S, or NR^(L).In certain embodiments, L is —CH₂—, —(CH₂)₂—, or —(CH₂)₃—. In certainembodiments, Ring B is substituted or unsubstituted cyclohexyl. Incertain embodiments, Ring B is a substituted or unsubstituted chromanyl.In certain embodiments, Ring B is substituted or unsubstituted phenyl.In certain embodiments, Ring B is substituted or unsubstitutedheteroaryl, e.g., substituted or unsubstituted pyridinyl or substitutedor unsubstituted benzimidazolyl.

Exemplary compounds of Formula (I) include, but are not limited to:

and pharmaceutically acceptable salts thereof and prodrugs thereof.Orexigenic Compounds

Pregnane derivatives are a class of steroid derivatives with carbonspresent at positions 1 through 21. As used herein, an “orexigeniccompound” means a pregnane or pregnene (e.g., pregnene, pregnadiene, orpregnatriene) compound that, when administered systemically to asubject, stimulates the appetite and/or food intake. Orexigeniccompounds specifically contemplated for use in the invention include,but are not limited to, megestrol, megestrol acetate,medroxyprogesterone, medroxyprogesterone acetate, and pharmaceuticallyacceptable salts and prodrugs thereof.

When administered systemically, megestrol acetate stimulates appetite bycentral mechanisms, and is therefore used to increase caloric balanceand promote weight gain, e.g., in patients with cancer- orHIV-associated cachexia. Megestrol acetate is also used as acontraceptive and as an antineoplastic agent, e.g., in the treatment ofbreast, endometrial, and prostate cancers. Although systemicadministration of megestrol acetate causes weight gain and/or obesity,it does not increase breast tissue. On the contrary, the endocrineprofile of megestrol acetate is such that it inhibits breast tissue.

In contrast, the present invention contemplates percutaneousadministration of an orexigenic compound for locally increasing bodyfat. For example, in another aspect, provided is a method for increasingfat locally in a subject in need thereof, the method comprisingadministering percutaneously to the subcutaneous fat of the subject anorexigenic compound, or a pharmaceutically acceptable salt or prodrugthereof. In certain embodiments, the administering step comprisestopical application to the skin using a percutaneous carrier, or byintradermal injection, subcutaneous injection, intramuscular injection,intralesional injection, transmucosal injection, or mucosal application.

In some embodiments, an orexigenic compound is a compound that, whenadministered systemically to a subject, causes a mean daily caloricintake in the subject that is greater than or equal to 200% of control,greater than or equal to 150% of control, greater than or equal to 125%of control, greater than or equal to 110% of control, greater than orequal to 105% of control, or greater than or equal to 100% of control,e.g., between about 100% to about 500%, between about 100% to about200%, between about 300% to about 400%, or between about 400% to about500% of control.

In certain embodiments, the orexigenic compound is a compound of Formula(II):

or a pharmaceutically acceptable salt or prodrug thereof;wherein:

each instance of

independently represents a single or double bond;

R¹ is hydrogen, hydroxyl, substituted hydroxyl, thiol, substitutedthiol, amino, or substituted amino;

R² is hydrogen, hydroxyl, substituted hydroxyl, thiol, substitutedthiol, amino, or substituted amino;

R³ is hydrogen or substituted or unsubstituted C₁₋₆alkyl;

R⁴ is hydrogen, hydroxyl, substituted hydroxyl, thiol, substitutedthiol, amino, or substituted amino, and R⁵ is hydrogen; or R⁴ and R⁵ arejoined to form an oxo group ═O.

In certain embodiments,

designated as “b” represents a double bond. In certain embodiments,

designated as “a” represents a double bond. In certain embodiments, eachinstance of

represents a double bond.

However, in certain embodiments,

designated as “b” represents a single bond. In certain embodiments,

designated as “a” represents a single bond, and in such an instance, thehydrogen at C5 is provided in the alpha or beta configuration. Incertain embodiments, each instance of

represents a single bond.

In certain embodiments,

designated as “b” represents a single bond, and

designated as “a” represents a double bond. In certain embodiments,

designated as “a” represents a single bond, and

designated as “b” represents a double bond.

In certain embodiments, R¹ is hydrogen. In certain embodiments, R¹ ishydroxyl. In certain embodiments, R¹ is substituted hydroxyl. In certainembodiments, R¹ is thiol. In certain embodiments, R¹ is substitutedthiol. In certain embodiments, R¹ is amino. In certain embodiments, R¹is substituted amino.

In certain embodiments, R² is hydrogen. In certain embodiments, R² ishydroxyl. In certain embodiments, R² is substituted hydroxyl. In certainembodiments, R² is thiol. In certain embodiments, R² is substitutedthiol. In certain embodiments, R² is amino. In certain embodiments, R²is substituted amino.

In certain embodiments, R³ is hydrogen. In certain embodiments, R³ issubstituted or unsubstituted C₁₋₆alkyl, e.g., substituted orunsubstituted C₁alkyl, substituted or unsubstituted C₂alkyl, substitutedor unsubstituted C₃alkyl, substituted or unsubstituted C₄alkyl,substituted or unsubstituted C₅alkyl, or substituted or unsubstitutedC₆alkyl. In certain embodiments, R³ is —CH₃ or —CH₂CH₃.

In certain embodiments, R⁴ is hydrogen and R⁵ is hydrogen. In certainembodiments, R⁴ is hydroxyl and R⁵ is hydrogen. In certain embodiments,R⁴ is substituted hydroxyl and R⁵ is hydrogen. In certain embodiments,R⁴ is thiol and R⁵ is hydrogen. In certain embodiments, R⁴ issubstituted thiol and R⁵ is hydrogen. In certain embodiments, R⁴ isamino and R⁵ is hydrogen. In certain embodiments, R⁴ is substitutedamino and R⁵ is hydrogen. In certain embodiments, R⁴ and R⁵ are joinedto form an oxo group ═O.

Various combinations of the above embodiments are contemplated herein.

For example, in certain embodiments, each instance of

represents a double bond, provided is a compound of Formula (II-a):

or a pharmaceutically acceptable salt or prodrug thereof. In certainembodiments, R¹ is hydrogen. In certain embodiments, R² is hydroxyl. Incertain embodiments, R² is substituted hydroxyl, e.g., —OC(═O)R^(aa),wherein R^(aa) is substituted or unsubstituted C₁₋₁₀alkyl. In certainembodiments, R⁴ is hydrogen and R⁵ is hydrogen. In certain embodiments,R³ is substituted or unsubstituted C₁₋₆alkyl, e.g., R³ is —CH₃.

In certain embodiments, wherein

designated as “b” represents a single bond, and

designated as “a” represents a double bond, provided is a compound ofFormula (II-b):

or a pharmaceutically acceptable salt or prodrug thereof. In certainembodiments, R¹ is hydrogen. In certain embodiments, R² is hydroxyl. Incertain embodiments, R² is substituted hydroxyl, e.g., —OC(═O)R^(aa),wherein R^(aa) is substituted or unsubstituted C₁₋₁₀alkyl. In certainembodiments, R⁴ is hydrogen and R⁵ is hydrogen. In certain embodiments,R³ is substituted or unsubstituted C₁₋₆alkyl, e.g., R³ is —CH₃. Incertain embodiments,

designated as “b” represents a single bond, and

designated as “a” represents a double bond. In certain embodiments, eachinstance of

represents a double bond.

Exemplary compounds of Formula (II) include, but are not limited to:

and pharmaceutically acceptable salts and prodrugs thereof.Use of Prodrugs According to the Invention

Without being bound by any particular theory, it is understood that oneor more of the above described compounds contemplated for administrationto a subject can exist as prodrugs. Accordingly, and without being boundby theory, the invention envisions, for example, that analogs of theabove compounds may comprise esters (e.g., —OC(═O)R^(aa) or—C(═O)OR^(aa) wherein R^(aa) is defined herein) and/or amides (e.g.,—NR^(bb)C(═O)R^(aa) or —C(═O)N(R^(bb))₂ wherein R^(aa) and R^(bb) are asdefined herein) that are substrates for hydrolases in the skin (e.g.,esterases, amidases). It is understood that compounds described hereinmay be substituted with esters, amides, and other hydrolyzable moietiesaccording to the desire to make a prodrug with more desirable propertiesfor percutaneous delivery as compared to the parent compound. Forexample, an ester form may penetrate the skin and/or partition inadipose tissue more effectively that the parent compound.

Methods of Treatment

As generally described herein, provided is a method for increasing fatlocally in a body of a subject in need thereof, the method comprisingpercutaneously delivering to the subcutaneous fat of the subject athiazolidinedione or an orexigenic compound, or a pharmaceuticallyacceptable salt or prodrug thereof. Delivering and administering areused interchangeably herein.

In certain embodiments, the delivering step comprises topicalapplication to the skin, or by intradermal injection, subcutaneousinjection, intramuscular injection, intralesional injection,transmucosal injection, or mucosal application.

In certain embodiments, percutaneously delivering comprises applying tothe skin a pharmaceutical composition comprising a thiazolidinedione oran orexigenic compound, or a pharmaceutically acceptable salt or prodrugthereof, and a percutaneous carrier.

In other embodiments, percutaneously delivering comprises administeringa pharmaceutical composition comprising a thiazolidinedione or anorexigenic compound, or a pharmaceutically acceptable salt or prodrugthereof, and a percutaneous carrier, by intradermal injection,subcutaneous injection, intramuscular injection, intralesionalinjection, transmucosal injection, or mucosal application.

In certain embodiments, the increasing fat locally in a body of asubject results in an increase in subcutaneous fat thickness at thetreated site on a subject (e.g., at least a 10%, at least a 20%, atleast a 30%, or at least a 40% increase in subcutaneous fat thickness)compared to a control site on the subject, or compared to the baseline(pre-administration) subcutaneous fat measurement, e.g., between 10% to100%, increase, inclusive. In certain embodiments, the increasing is atleast 10% greater at the treatment site than at a control site orcompared to the baseline measurement. In certain embodiments, theincreasing is at least 20% greater at the treatment site than at acontrol site or compared to the baseline measurement. In certainembodiments, the increasing is at least 30% greater at the treatmentsite than at a control site or compared to the baseline measurement. Incertain embodiments, the increasing is at least 40% greater at thetreatment site than at a control site or compared to the baselinemeasurement.

In some embodiments, the subject suffers from a subcutaneous fatdeficiency, and the method is directed to treating the subcutaneous fatdelivery.

In some embodiments, the subcutaneous fat deficiency is associated witha metabolic disorder. Exemplary metabolic disorders associated withsubcutaneous fat deficiency include, but are not limited to, insulinresistance, diabetes (e.g., lipoatrophic diabetes), lipase deficiency,wasting, malnutrition, paraneoplastic condition, anorexia, perniciousanemia, celiac disease, and malabsorption syndrome.

In some embodiments, the subcutaneous fat deficiency is associated withan inflammatory condition. Exemplary inflammatory conditions associatedwith subcutaneous fat deficiency include, but are not limited to,complement component 3 (C3) deficiency, membranoproliferativeglomerulonephritis, systemic lupus erythematosus, dermatomyositis,rheumatoid arthritis, temporal arteritis, and leukocytoclasticvasculitis.

In some embodiments, the subcutaneous fat deficiency is acquired. Asused herein, “acquired” means a disorder that is not congenital.Exemplary conditions associated with acquired subcutaneous fatdeficiency include, but are not limited to, HIV-associatedlipodystrophy, lipidema, acquired partial lipodystrophy(Barraquer-Simons syndrome), acquired generalized lipodystrophy,Parry-Roberg syndrome, juvenile dermatomyositis, centrifugal abdominallipodystrophy (lipodystrophia centrifugalis abdominalis infantilis),lipoatrophia annularis (Ferreira-Marques lipoatrophia), and localizedlipodystrophy.

In some embodiments, the subcutaneous fat deficiency is congenital.Exemplary congenital conditions associated with subcutaneous fatdeficiency include, but are not limited to, congenital generalizedlipodystrophy (Beradinelli-Seip syndrome), familial partial dystrophy(e.g., Kobberling-type, Dunnigan type, or Type 3), Nakajo-Nishimurasyndrome, Cockayne syndrome, SHORT syndrome, AREDYLD syndrome,mandibuloacral dysplasia, Keppen-Lubinsky syndrome, POEMS syndrome,Werner syndrome, Hutchinson-Gilford syndrome, and progeria.

In some embodiments, the subcutaneous fat deficiency is caused by alipoatrophy-causing mutation in a gene selected from the groupconsisting of APLD, AKT2, C3, CAV1, CGL1 (AGPAT2), and CGL2 (BSCL2),LMF1, LMNA, PLIN1, PPARG, PSMB8, PTRF, and ZMPSTE24.

In some embodiments, the subcutaneous fat deficiency is caused by amedication. Exemplary medications known to cause subcutaneous fatdeficiency include, but are not limited to, an antiretroviral (see,e.g., Domingo et al., AIDS Rev 2012; 14:112-123), an antibiotic (see,e.g., Kayikcioglu et al., J Pediatr 1996; 129:166-167), iron, a growthhormone, a detergent (see, e.g., U.S. Pat. No. 7,622,130), and acorticosteroid and/or a beta-adrenergic agonist (see, e.g, U.S. patentapplication Ser. No. 13/204,423). Exemplary antiretroviral medicationsare non-nucleoside reverse transcriptase inhibitors (e.g., efavirenz),nucleoside/nucleotide analog reverse transcriptase inhibitors (e.g.,zidovudine), and HIV-1 protease inhibitors (e.g., nelfinavir). Exemplarycorticosteroids include fluticasone, triamcinolone, betamethasone,prednisolone, methylprednisolone, and dexamethasone. Exemplaryantibiotics include penicillin. An exemplary beta-adrenergic agonists issalmeterol. An exemplary detergent is deoxycholate.

In some embodiments, the subcutaneous fat deficiency is caused bysurgery. For example, thiazolidinediones and/or an orexigenic compounds,as described herein, may also be useful as an adjunct to any of variouskinds of surgery, whether used in the pre-operative, peri-operative, orpost-operative period.

In some embodiments, a loss or deficiency of fat is caused by an injury.In some embodiments, the injury is selected from the group consisting ofmechanical injury, burn, cryoinjury, and radiation injury.

In some embodiments, the subject does not necessarily suffer from adeficiency of fat.

For example, in some embodiments, the subject suffers from wrinkles ofthe skin, e.g., the skin is affected by wrinkles, and the method isdirected to treating the wrinkles, e.g., by minimizing the appearance ofwrinkles.

In certain embodiments, the skin is on the face, forehead, periorbitalregion of the face, midface, cheeks, chin, lips, breast, limbs, hands,trunk, hips, or buttocks.

In other embodiments, the subject suffers from dissatisfaction with thesize or contour of a body part, and the method is directed to modifyingthe contour of the body part. As used herein, “modifying the contour ofa body part” refers to changing the shape of the body part, for example,by augmenting the whole body part, by augmenting one or more area of thebody part, or by augmenting one or more areas neighboring the body part.For example, the contour of the cheeks could be modified by augmentingthe cheeks as a whole, by selectively augmenting only a portion of thecheeks (e.g., the malar eminences). Selective augmentation of aparticular area is obtained by selectively treating the particular area,as described herein. Exemplary body parts contemplated for modificationinclude, for example, the head (e.g., face such as the forehead,forehead, periorbital region, cheeks, chin, lips, and other anteriorstructures from top of forehead to bottom of chin), breast, limbs,hands, trunk, hips, and buttocks. In some embodiments, the methodfurther comprises modifying the contour of the face. In someembodiments, the method further comprises modifying the contour of thecheeks. In some embodiments, the method further comprises modifying thecontour of the chin. In some embodiments, the method further comprisesmodifying the contour of the jaw. In some embodiments, the methodfurther comprises modifying the contour of the lips. In someembodiments, the method further comprises modifying the contour of abreast or breasts. In some embodiments, the method further comprisesmodifying the contour of a limb or limbs. In some embodiments, themethod further comprises modifying the contour of the hands. In someembodiments, the method further comprises modifying the contour of thehips. In some embodiments, the method further comprises modifying thecontour of the buttocks.

In yet other embodiments, the subject has transplanted fat, and themethod is directed to augmenting the transplanted fat.

In certain embodiments, the subject suffers from diabetes, HIV, familiallipodystrophy, or a subcutaneous fat deficiency

Pharmaceutical and Cosmetic Compositions

As generally described herein, provided are compositions forpercutaneous administration comprising an active ingredient and apharmaceutically acceptable carrier.

As used herein, a “composition” refers to a pharmaceutical composition(e.g., useful for treatment of a particular disease, disorder, orcondition, such as diagnosed by a medical professional) or cosmeticcomposition (e.g., for beautification purposes). Carrier and excipientare used interchangeably herein. Furthermore, as used herein, an “activeingredient” refers to a thiazolidinedione and/or an orexigenic compound,as described herein. In certain embodiments, the active ingredient isprovided in a therapeutically effective amount in the composition.

In certain embodiments, the pharmaceutically acceptable carriercomprises a percutaneous carrier, and in this instance, thepharmaceutically acceptable carrier as a whole is viewed as apercutaneous carrier. In certain embodiments, the composition comprisesa percutaneous carrier. In certain embodiments, the compositioncomprises a carrier (optionally a percutaneous carrier) for intradermalinjection, subcutaneous injection, intramuscular injection,intralesional injection, transmucosal injection, or mucosal application.In certain embodiments, the composition further comprises one or morefatty acids. In certain embodiments, the composition further comprisesone or more organic alcohols. In certain embodiments, the compositionfurther comprises a penetration enhancer.

Exemplary pharmaceutically acceptable carriers include any and allsolvents or other liquid vehicles, dispersion or suspension aids,surface active agents, isotonic agents, thickening or emulsifyingagents, preservatives, buffering agents, lubricants and the like, assuited to the particular mode of administration desired.

General considerations in the formulation and/or manufacture ofcompositions can be found, for example, in Remington's PharmaceuticalSciences, Sixteenth Edition, E. W. Martin (Mack Publishing Co., Easton,Pa., 1980), and Remington: The Science and Practice of Pharmacy, 21^(st)Edition (Lippincott Williams & Wilkins, 2005). See also Singh et al.,Local deep tissue penetration of compounds after dermal application:structure-tissue penetration relationships. JPET (1996) 279:908-917.

Compositions described herein can be prepared by any method known in theart of pharmacology. In general, such preparatory methods include thesteps of bringing the active ingredient into association with a carrierand/or one or more other accessory ingredients, and then, if necessaryand/or desirable, shaping and/or packaging the product into a desiredsingle- or multi-dose unit.

Compositions can be prepared, packaged, and/or sold in bulk, as a singleunit dose, and/or as a plurality of single unit doses. As used herein, a“unit dose” is discrete amount of the composition comprising apredetermined amount of the active ingredient. The amount of the activeingredient is generally equal to the dosage of the active ingredientwhich would be administered to a subject and/or a convenient fraction ofsuch a dosage such as, for example, one-half or one-third of such adosage.

Relative amounts of the active ingredient, the pharmaceuticallyacceptable carrier, and/or any additional ingredients in a compositionwill vary, depending upon the identity, size, and/or condition of thesubject treated and further depending upon the route by which thecomposition is to be administered. By way of example, the compositionmay comprise between 0.1% and 100% (w/w) active ingredient.

Exemplary granulating and/or dispersing agents include potato starch,corn starch, tapioca starch, sodium starch glycolate, clays, alginicacid, guar gum, citrus pulp, agar, bentonite, cellulose and woodproducts, natural sponge, cation-exchange resins, calcium carbonate,silicates, sodium carbonate, cross-linked poly(vinyl-pyrrolidone)(crospovidone), sodium carboxymethyl starch (sodium starch glycolate),carboxymethyl cellulose, cross-linked sodium carboxymethyl cellulose(croscarmellose), methylcellulose, pregelatinized starch (starch 1500),microcrystalline starch, water insoluble starch, calcium carboxymethylcellulose, magnesium aluminum silicate (Veegum), sodium lauryl sulfate,quaternary ammonium compounds, etc., and combinations thereof.

Exemplary surface active agents and/or emulsifiers includelipids/natural emulsifiers (e.g. acacia, agar, alginic acid, sodiumalginate, tragacanth, chondrux, cholesterol, xanthan, pectin, gelatin,egg yolk, casein, wool fat, cholesterol, wax, and lecithin), colloidalclays (e.g. bentonite [aluminum silicate] and Veegum [magnesium aluminumsilicate]), long chain amino acid derivatives, high molecular weightalcohols (e.g. stearyl alcohol, cetyl alcohol, oleyl alcohol, triacetinmonostearate, ethylene glycol distearate, glyceryl monostearate, andpropylene glycol monostearate, polyvinyl alcohol), carbomers (e.g.carboxy polymethylene, polyacrylic acid, acrylic acid polymer, andcarboxyvinyl polymer), carrageenan, cellulosic derivatives (e.g.carboxymethylcellulose sodium, powdered cellulose, hydroxymethylcellulose, hydroxypropyl cellulose, hydroxypropyl methylcellulose,methylcellulose), sorbitan fatty acid esters (e.g. polyoxyethylenesorbitan monolaurate [Tween 20], polyoxyethylene sorbitan [Tween 60],polyoxyethylene sorbitan monooleate [Tween 80], sorbitan monopalmitate[Span 40], sorbitan monostearate [Span 60], sorbitan tristearate [Span65], glyceryl monooleate, sorbitan monooleate [Span 80]),polyoxyethylene esters (e.g. polyoxyethylene monostearate [Myrj 45],polyoxyethylene hydrogenated castor oil, polyethoxylated castor oil,polyoxymethylene stearate, and Solutol), sucrose fatty acid esters,polyethylene glycol fatty acid esters (e.g. Cremophor), polyoxyethyleneethers, (e.g. polyoxyethylene lauryl ether [Brij 30]),poly(vinyl-pyrrolidone), diethylene glycol monolaurate, triethanolamineoleate, sodium oleate, potassium oleate, ethyl oleate, oleic acid, ethyllaurate, sodium lauryl sulfate, Pluronic F 68, Poloxamer 188,cetrimonium bromide, cetylpyridinium chloride, benzalkonium chloride,docusate sodium, etc. and/or combinations thereof.

Exemplary preservatives include antioxidants, chelating agents,antimicrobial preservatives, antifungal preservatives, alcoholpreservatives, acidic preservatives, and other preservatives.

Exemplary antioxidants include alpha tocopherol, ascorbic acid, acorbylpalmitate, butylated hydroxyanisole, butylated hydroxytoluene,monothioglycerol, potassium metabisulfite, propionic acid, propylgallate, sodium ascorbate, sodium bisulfite, sodium metabisulfite, andsodium sulfite.

Exemplary chelating agents include ethylenediaminetetraacetic acid(EDTA) and salts and hydrates thereof (e.g., sodium edetate, disodiumedetate, trisodium edetate, calcium disodium edetate, dipotassiumedetate, and the like), citric acid and salts and hydrates thereof(e.g., citric acid monohydrate), fumaric acid and salts and hydratesthereof, malic acid and salts and hydrates thereof, phosphoric acid andsalts and hydrates thereof, and tartaric acid and salts and hydratesthereof. Exemplary antimicrobial preservatives include benzalkoniumchloride, benzethonium chloride, benzyl alcohol, bronopol, cetrimide,cetylpyridinium chloride, chlorhexidine, chlorobutanol, chlorocresol,chloroxylenol, cresol, ethyl alcohol, glycerin, hexetidine, imidurea,phenol, phenoxyethanol, phenylethyl alcohol, phenylmercuric nitrate,propylene glycol, and thimerosal.

Exemplary antifungal preservatives include butyl paraben, methylparaben, ethyl paraben, propyl paraben, benzoic acid, hydroxybenzoicacid, potassium benzoate, potassium sorbate, sodium benzoate, sodiumpropionate, and sorbic acid.

Exemplary alcohol preservatives include ethanol, polyethylene glycol,phenol, phenolic compounds, bisphenol, chlorobutanol, hydroxybenzoate,and phenylethyl alcohol.

Exemplary acidic preservatives include vitamin A, vitamin C, vitamin E,beta-carotene, citric acid, acetic acid, dehydroacetic acid, ascorbicacid, sorbic acid, and phytic acid.

Other preservatives include tocopherol, tocopherol acetate, deteroximemesylate, cetrimide, butylated hydroxyanisol (BHA), butylatedhydroxytoluened (BHT), ethylenediamine, sodium lauryl sulfate (SLS),sodium lauryl ether sulfate (SLES), sodium bisulfite, sodiummetabisulfite, potassium sulfite, potassium metabisulfite, Glydant Plus,Phenonip, methylparaben, Germall 115, Germaben II, Neolone, Kathon, andEuxyl. In certain embodiments, the preservative is an anti-oxidant. Inother embodiments, the preservative is a chelating agent.

Exemplary buffering agents include citrate buffer solutions, acetatebuffer solutions, phosphate buffer solutions, ammonium chloride, calciumcarbonate, calcium chloride, calcium citrate, calcium glubionate,calcium gluceptate, calcium gluconate, D-gluconic acid, calciumglycerophosphate, calcium lactate, propanoic acid, calcium levulinate,pentanoic acid, dibasic calcium phosphate, phosphoric acid, tribasiccalcium phosphate, calcium hydroxide phosphate, potassium acetate,potassium chloride, potassium gluconate, potassium mixtures, dibasicpotassium phosphate, monobasic potassium phosphate, potassium phosphatemixtures, sodium acetate, sodium bicarbonate, sodium chloride, sodiumcitrate, sodium lactate, dibasic sodium phosphate, monobasic sodiumphosphate, sodium phosphate mixtures, tromethamine, magnesium hydroxide,aluminum hydroxide, alginic acid, pyrogen-free water, isotonic saline,Ringer's solution, ethyl alcohol, etc., and combinations thereof.

Exemplary lubricating agents include magnesium stearate, calciumstearate, stearic acid, silica, talc, malt, glyceryl behanate,hydrogenated vegetable oils, polyethylene glycol, sodium benzoate,sodium acetate, sodium chloride, leucine, magnesium lauryl sulfate,sodium lauryl sulfate, etc., and combinations thereof.

Exemplary oils include almond, apricot kernel, avocado, babassu,bergamot, black current seed, borage, cade, camomile, canola, caraway,carnauba, castor, cinnamon, cocoa butter, coconut, cod liver, coffee,corn, cotton seed, emu, eucalyptus, evening primrose, fish, flaxseed,geraniol, gourd, grape seed, hazel nut, hyssop, isopropyl myristate,jojoba, kukui nut, lavandin, lavender, lemon, litsea cubeba, macademianut, mallow, mango seed, meadowfoam seed, mink, nutmeg, olive, orange,orange roughy, palm, palm kernel, peach kernel, peanut, poppy seed,pumpkin seed, rapeseed, rice bran, rosemary, safflower, sandalwood,sasquana, savoury, sea buckthorn, sesame, shea butter, silicone,soybean, sunflower, tea tree, thistle, tsubaki, vetiver, walnut, andwheat germ oils. Exemplary oils include, but are not limited to, butylstearate, caprylic triglyceride, capric triglyceride, cyclomethicone,diethyl sebacate, dimethicone 360, isopropyl myristate, mineral oil,octyldodecanol, oleyl alcohol, silicone oil, and combinations thereof.

Injectable preparations, for example, sterile injectable aqueous oroleaginous suspensions can be formulated according to the known artusing suitable dispersing or wetting agents and suspending agents. Thesterile injectable preparation can be a sterile injectable solution,suspension or emulsion in a nontoxic parenterally acceptable diluent orsolvent, for example, as a solution in 1,3-butanediol. Among theacceptable vehicles and solvents that can be employed are water,Ringer's solution, U.S.P. and isotonic sodium chloride solution. Inaddition, sterile, fixed oils are conventionally employed as a solventor suspending medium. For this purpose any bland fixed oil can beemployed including synthetic mono- or diglycerides. In addition, fattyacids such as oleic acid are used in the preparation of injectables. Theinjectable formulations can be sterilized, for example, by filtrationthrough a bacterial-retaining filter, or by incorporating sterilizingagents in the form of sterile solid compositions which can be dissolvedor dispersed in sterile water or other sterile injectable medium priorto use. Suitable devices for injection, e.g., for intradermal injection,subcutaneous injection, intramuscular injection, intralesionalinjection, or transmucosal injection, of the active ingredient includeshort needle devices such as those described in U.S. Pat. Nos.4,886,499; 5,190,521; 5,328,483; 5,527,288; 4,270,537; 5,015,235;5,141,496; and 5,417,662. The active ingredient can be administered bydevices which limit the effective penetration length of a needle intothe skin, such as those described in PCT publication WO 99/34850 andfunctional equivalents thereof. Alternatively or additionally,conventional syringes can be used.

Dosage forms for topical administration (e.g., percutaneousadministration to the skin, mucosal administration to the mucosa) of anactive ingredient may include ointments, pastes, creams, lotions, gels,powders, ointment, paste, solutions, sprays, inhalants and/or patches.Such dosage forms can be prepared, for example, by dissolving and/ordispensing the active ingredient in the proper medium. Generally, theactive ingredient is admixed under sterile conditions with apharmaceutically acceptable carrier and/or any needed preservativesand/or buffers as can be required. Additionally, the present inventioncontemplates the use of patches, e.g., “percutaneous” patches, whichoften have the added advantage of providing controlled delivery of theactive ingredient. Alternatively or additionally, the rate can becontrolled by either providing a rate controlling membrane and/or bydispersing the active ingredient in a polymer matrix and/or gel.

An exemplary percutaneous patch contemplated herein can be made bycombining the active ingredient and percutaneous carrier with anadhesive, and applying a layer of the combined activeingredient/carrier/adhesive to a solid matrix, e.g, a fabric mesh orplastic sheet. Methods for making transdermal patches are known in theart (see, e.g., Williams A C. Transdermal and Topical Drug Delivery,London: Pharmaceutical Press, 2003) and can be adapted for percutaneousdelivery, with the proviso that the carrier and active ingredientconcentration are adapted for percutaneous rather than transdermaldelivery, as defined herein.

A percutaneous carrier is a pharmaceutically acceptable carrier adaptedto deliver an active ingredient percutaneously, e.g., to subcutaneousfat. See, for example, Singh et al., Local deep tissue penetration ofcompounds after dermal application: structure-tissue penetrationrelationships. JPET (1996) 279:908-917. An exemplary percutaneouscarrier in a marketed medication (Pennsaid® [diclofenac 1.5% topicalsolution]) is an aqueous solution comprising about 45% w/w dimethylsulfoxide, with lesser amounts of propylene glycol, alcohol, andglycerin). Other exemplary percutaneous carriers include, but are notlimited to, Lipoderm®, Vanpen®, HRT base, Occlusaderm®, and a Pluronic®lecithin organogel. See, e.g., Kumar et al., AAPS PharmSciTech (2005)6:E298-E310. See also Examples 1-11 providing working examples ofpercutaneous carriers.

In certain embodiments, the percutaneous carrier (or composition)comprises one or more fatty acids. In some embodiments, the finalconcentration of the one or more fatty acids is between about 1 percentto about 20 percent by weight, inclusive. In some embodiments, the finalconcentration of the one or more fatty acids is between about 5 andabout 15 percent, about 1 and about 10 percent, about 1 and about 2percent, about 1 and about 3 percent, about 1 and about 5 percent, about2 and about 4 percent, about 3 and about 5 percent, about 3 and about 7percent, about 4 and about 6 percent, about 5 and about 7 percent, about6 and about 8 percent, about 7 and about 10 percent, about 10 and about20 percent, about 10 and about 15 percent, or about 15 and about 20percent. In certain embodiments, the final concentration of the one ormore fatty acids in the composition is 1, 2, 3, 4, 5, 6, 7, 8, 9, 10,11, 12, 13, 14, 15, 16, 17, 18, 19, or 20 percent by weight.

In certain embodiments, the percutaneous carrier comprises the fattyacid oleic acid. However, the skilled artisan will appreciate that oleicacid can be substituted by one or more fatty acids of similar structure,e.g., wherein the acyl moiety of the fatty acid (R^(FA1)) is optionallysubstituted C₁₀-C₂₀ alkyl or optionally substituted C₁₀-C₂₀ alkenyl.

In certain embodiments, R^(FA1) is an optionally substituted C₁₀-C₁₉alkyl, C₁₀-C₁₈ alkyl, C₁₀-C₁₇ alkyl, C₁₀-C₁₆ alkyl, C₁₀-C₁₅ alkyl,C₁₀-C₁₄ alkyl, C₁₀-C₁₃ alkyl, C₁₁-C₂₀ alkyl, C₁₁-C₁₉ alkyl, C₁₁-C₁₈alkyl, C₁₁-C₁₇ alkyl, C₁₁-C₁₆ alkyl, C₁₁-C₁₅ alkyl, C₁₁-C₁₄ alkyl,C₁₁-C₁₃ alkyl, C₁₂-C₁₉ alkyl, C₁₂-C₁₈ alkyl, C₁₂-C₁₇ alkyl, C₁₂-C₁₆alkyl, C₁₂-C₁₅ alkyl, C₁₂-C₁₄ alkyl, C₁₂-C₁₃ alkyl, C₁₃-C₂₀ alkyl,C₁₃-C₁₉ alkyl, C₁₃-C₁₈ alkyl, C₁₃-C₁₇ alkyl, C₁₃-C₁₆ alkyl, C₁₃-C₁₅alkyl, C₁₃-C₁₄ alkyl, C₁₄-C₂₀ alkyl, C₁₄-C₁₉ alkyl, C₁₄-C₁₈ alkyl,C₁₄-C₁₇ alkyl, C₁₄-C₁₆ alkyl, C₁₄-C₁₅ alkyl, C₁₅-C₂₀ alkyl, C₁₅-C₁₉alkyl, C₁₅-C₁₈ alkyl, C₁₅-C₁₇ alkyl, or C₁₅-C₁₆ alkyl. In certainembodiments, R^(FA1) is a straight chain (unbranched) alkyl group. Incertain embodiments, R^(FA1) is an unsubstituted alkyl group, i.e.,comprising only carbon and hydrogen atoms. In certain embodiments,R^(FA1) is a substituted alkyl group, e.g., substituted by halogenatoms.

In certain embodiments, R^(FA1) is an optionally substituted C₁₀-C₁₉alkenyl, C₁₀-C₁₈ alkenyl, C₁₀-C₁₇ alkenyl, C₁₀-C₁₆ alkenyl, C₁₀-C₁₅alkenyl, C₁₀-C₁₄ alkenyl, C₁₀-C₁₃ alkenyl, C₁₁-C₂₀ alkenyl, C₁₁-C₁₉alkenyl, C₁₁-C₁₈ alkenyl, C₁₁-C₁₇ alkenyl, C₁₁-C₁₆ alkenyl, C₁₁-C₁₅alkenyl, C₁₁-C₁₄ alkenyl, C₁₁-C₁₃ alkenyl, C₁₂-C₁₉ alkenyl, C₁₂-C₁₈alkenyl, C₁₂-C₁₇ alkenyl, C₁₂-C₁₆ alkenyl, C₁₂-C₁₅ alkenyl, C₁₂-C₁₄alkenyl, C₁₂-C₁₃ alkenyl, C₁₃-C₂₀ alkenyl, C₁₃-C₁₉ alkenyl, C₁₃-C₁₈alkenyl, C₁₃-C₁₇ alkenyl, C₁₃-C₁₆ alkenyl, C₁₃-C₁₅ alkenyl, C₁₃-C₁₄alkenyl, C₁₄-C₂₀ alkenyl, C₁₄-C₁₉ alkenyl, C₁₄-C₁₈ alkenyl, C₁₄-C₁₇alkenyl, C₁₄-C₁₆ alkenyl, C₁₄-C₁₅ alkenyl, C₁₅-C₂₀ alkenyl, C₁₅-C₁₉alkenyl, C₁₅-C₁₈ alkenyl, C₁₅-C₁₇ alkenyl, C₁₅-C₁₆ alkenyl. In certainembodiments, R^(FA1) is a unbranched alkenyl group. In certainembodiments, R^(FA1) is an unsubstituted alkenyl group, i.e., comprisingonly carbon and hydrogen atoms. In certain embodiments, R^(FA1) is asubstituted alkenyl group, e.g., substituted by halogen atoms. Incertain embodiments, R^(FA1) is an alkenyl group comprising 1, 2, 3, or4 double bonds, each independently cis or trans.

In certain embodiments, R^(FA1) is an alkenyl group comprising at leastone cis double bond, e.g., 1, 2, 3, or 4 cis double bonds. In certainembodiments, R^(FA1) is an alkenyl group of formula (a):

wherein:

-   -   p is an integer between 2 and 8, inclusive;    -   q is an integer between 1 and 8, inclusive; and    -   R^(FA2) is an optionally substituted C₁-C₁₀ alkyl, or an        optionally substituted C₂-C₁₀alkenyl, provided the sum of        carbons of formula (a) does not exceed 20.

In certain embodiments, R^(FA2) is an optionally substituted C₁-C₉alkyl, C₁-C₈ alkyl, C₁-C₇ alkyl, C₁-C₆ alkyl, C₁-C₅ alkyl, C₁-C₄ alkyl,C₁-C₃ alkyl, C₁-C₂ alkyl, C₂-C₁₀ alkyl, C₂-C₉ alkyl, C₂-C₈ alkyl, C₂-C₇alkyl, C₂-C₆ alkyl, C₂-C₅ alkyl, C₂-C₄ alkyl, C₂-C₃ alkyl, C₃-C₁₀ alkyl,C₃-C₉ alkyl, C₃-C₈ alkyl, C₃-C₇ alkyl, C₃-C₆ alkyl, C₃-C₅ alkyl, C₃-C₄alkyl, C₄-C₁₀ alkyl, C₄-C₉ alkyl, C₄-C₈ alkyl, C₄-C₇ alkyl, C₄-C₆ alkyl,C₄-C₅ alkyl, C₅-C₁₀ alkyl, C₅-C₉ alkyl, C₅-C₈ alkyl, C₅-C₇ alkyl, C₅-C₆alkyl, C₆-C₁₀ alkyl, C₆-C₉ alkyl, C₆-C₈ alkyl, C₆-C₇ alkyl, C₇-C₁₀alkyl, C₇-C₉ alkyl, C₇-C₈ alkyl, C₈-C₁₀ alkyl, C₈-C₉ alkyl, or C₉-C₁₀alkyl. In certain embodiments, R^(FA2) is a straight chain (unbranched)alkyl group. In certain embodiments, R^(FA2) is an unsubstituted alkylgroup, i.e., comprising only carbon and hydrogen atoms. In certainembodiments, R^(FA2) is a substituted alkyl group, e.g., substituted byhalogen atoms.

In certain embodiments, R^(FA2) is an optionally substituted C₂-C₉alkenyl, C₂-C₈ alkenyl, C₂-C₇ alkenyl, C₂-C₆ alkenyl, C₂-C₅ alkenyl,C₂-C₄ alkenyl, C₂-C₃ alkenyl, C₃-C₁₀ alkenyl, C₃-C₉ alkenyl, C₃-C₈alkenyl, C₃-C₇ alkenyl, C₃-C₆ alkenyl, C₃-C₅ alkenyl, C₃-C₄ alkenyl,C₄-C₁₀ alkenyl, C₄-C₉ alkenyl, C₄-C₈ alkenyl, C₄-C₇ alkenyl, C₄-C₆alkenyl, C₄-C₅ alkenyl, C₅-C₁₀ alkenyl, C₅-C₉ alkenyl, C₅-C₈ alkenyl,C₅-C₇ alkenyl, C₅-C₆ alkenyl, C₆-C₁₀ alkenyl, C₆-C₉ alkenyl, C₆-C₈alkenyl, C₆-C₇ alkenyl, C₇-C₁₀ alkenyl, C₇-C₉ alkenyl, C₇-C₈ alkenyl,C₈-C₁₀ alkenyl, C₈-C₉ alkenyl, or C₉-C₁₀ alkenyl. In certainembodiments, R^(FA2) is a straight chain (unbranched) alkenyl group. Incertain embodiments, R^(FA2) is an unsubstituted alkenyl group, i.e.,comprising only carbon and hydrogen atoms. In certain embodiments,R^(FA2) is a substituted alkenyl group, e.g., substituted by halogenatoms. In certain embodiments, R^(FA2) is a substituted alkenyl group,e.g., substituted by halogen atoms. In certain embodiments, R^(FA2) isan alkenyl group comprising 1 or 2 double bonds, each independently cisor trans.

In certain embodiments, R^(FA1) is selected from any one of thefollowing saturated or unsaturated fatty acyl moieties:

Lauric —(CH₂)₁₀CH₃ (11 aliphatic carbons), Myristic —(CH₂)₁₂CH₃ (13aliphatic carbons), Palmitic —(CH₂)₁₄CH₃ (15 aliphatic carbons), Stearic—(CH₂)₁₆CH₃ (17 aliphatic carbons), Myristoleic —(CH₂)₇CH═CH(CH₂)₃CH₃,

-   -   i.e., of formula

-   -    wherein p=7, q=3, R^(FA2)=—CH₃ (13 aliphatic carbons)        Palmitoliec* —(CH₂)₇CH═CH(CH₂)₅CH₃,    -   i.e., of formula

-   -    wherein p=7, q=5, R^(FA2)=—CH₃ (15 aliphatic carbons)        Sapienic* —(CH₂)₄CH═CH(CH₂)₈CH₃,    -   i.e., of formula

-   -    wherein p=4, q=8, R^(FA2)=—CH₃ (15 aliphatic carbons)        Oleic —(CH₂)₇CH═CH(CH₂)₇CH₃,    -   i.e., of formula

-   -    wherein p=7, q=7, R^(FA2)=—CH₃ (17 aliphatic carbons)        Linoleic* —(CH₂)₇CH═CHCH₂CH═CH(CH₂)₄CH₃,    -   i.e., of formula

-   -    wherein p=7, q=1, R^(FA2)=C₇-alkenyl (17 aliphatic carbons)        α-Linolenic** —(CH₂)₇CH═CHCH₂CH═CHCH₂CH═CHCH₂CH₃    -   i.e., of formula

-   -    wherein p=7, q=1, R^(FA2)=C₇-alkenyl (17 aliphatic carbons)

In some embodiments, the percutaneous carrier (or composition) comprisesone or more organic alcohols, e.g., R^(aa)—OH, wherein R^(aa) is asdefined herein. In certain embodiments, R^(aa) is C₁₋₁₀ alkyl, C₁₋₁₀perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, heteroC₁₋₁₀ alkyl,heteroC₂₋₁₀ alkenyl, or heteroC₂₋₁₀alkynyl, wherein each alkyl, alkenyl,alkynyl, heteroalkyl, heteroalkenyl, and heteroalkynyl is independentlysubstituted with 0, 1, 2, 3, 4, or 5 R^(dd) groups, as defined herein(e.g., substituted by —OH or —OR^(ee), as defined herein). In certainembodiments, R^(aa) is C₁₋₁₀ alkyl, e.g., C₁₋₉ alkyl, C₁₋₈alkyl, C₁₋₆alkyl, C₁₋₄ alkyl, C₁₋₃ alkyl, C₁₋₂ alkyl, C₂₋₁₀ alkyl, C₂₋₉ alkyl, C₂₋₈alkyl, C₂₋₆ alkyl, C₂₋₄ alkyl, or C₂₋₃ alkyl. In certain embodiments,R^(aa) is an unsubstituted alkyl group. In certain embodiments, Raa is asubstituted alkyl group, e.g., substituted with 1, 2, 3, 4, or 5 R^(dd)groups, as defined herein (e.g., substituted by —OH or —OR^(ee), asdefined herein). Exemplary organic alcohols include, but are not limitedto, methanol, ethanol, propanol, isopropanol, 1,3-butanediol, propyleneglycol, or ethylene glycol. In certain embodiments, the percutaneouscarrier comprises propylene glycol and/or ethanol. In some embodiments,the final concentration of the one or more organic alcohols in thecomposition is between about 5 percent and about 99 percent by weight,inclusive.

In some embodiments, the percutaneous carrier (or composition) comprisesone or more organic alcohols which acts as a base excipient (i.e.,constituting the major component of the composition). In someembodiments, the final concentration of the organic alcohol baseexcipient in the composition is greater than 50 percent and about 99percent by weight, inclusive. In some embodiments, the finalconcentration of the organic alcohol base excipient in the compositionis between about 51 percent and 60 percent, 51 percent and about 70percent, about 60 percent and about 70 percent, about 60 percent andabout 80 percent, about 70 percent and about 80 percent, about 70percent and about 90 percent, about 80 percent and about 90 percent,about 85 percent and about 95 percent, about 90 percent and about 95percent, about 90 percent and about 99 percent, and about 95 percent andabout 99 percent, inclusive. In certain embodiments, the organic alcoholwhich acts as a base excipient is ethanol.

In some embodiments, the percutaneous carrier (or composition) comprisesone or more organic alcohols which is not the base component of thecomposition (e.g., provided as a component in 50% or less by weight). Incertain embodiments, the final concentration of the organic alcohol inthe composition is between about 5 percent and about 50 percent byweight, inclusive. In some embodiments, the final concentration of theorganic alcohol is between about 5 percent and 10 percent, about 5percent and about 15 percent, about 10 percent and about 15 percent,about 10 percent and about 20 percent, about 10 percent and about 30percent, about 10 percent and about 40 percent, about 15 percent andabout 20 percent, about 15 percent and about 25 percent, about 20percent and about 25 percent, about 20 percent and 30 percent, about 25percent and about 30 percent, about 25 percent and about 35 percent,about 30 percent and about 35 percent, about 30 percent and about 40percent, about 35 percent and about 40 percent, about 35 percent andabout 45 percent, about 40 percent and about 50 percent, about 40percent and about 45 percent, or about 45 percent and about 50 percent,inclusive. In certain embodiments, the percutaneous carrier comprises anorganic alcohol, wherein the organic alcohol is present in 1, 2, 3, 4,5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23,24, 25, 26, 27, 28, 29, or 30% by weight in the composition. In certainembodiments, the organic alcohol that is not the base component of thecomposition is propylene glycol.

In certain embodiments, the percutaneous carrier (or composition)further comprises a penetration enhancer. A variety of penetrationenhancers are known in the art, e.g., enzymes, lactams, propyleneglycol, alcohols such as ethanol and propanol, polyols, limonene,terpenes, dioxolane, propylene glycol, ethylene glycol, other glycols,glycerol, sulfoxides such as dimethylsulfoxide (DMSO) and methyl dodecylsulfoxide, esters such as isopropyl myristate/palmitate, ethyl acetate,butyl acetate, methyl propionate, and capric/caprylic triglycerides,ketones, such as 2-alkyl cyclohexanones, t-butyl cyclohexanones, andvarious C₈ derivatives; amides, such as acetamides; oleates, such astriolein; various surfactants, such as Brij 96, Tweens (Atlas ChemicalCompany), and sodium lauryl sulfate; various alkanoic acids such ascaprylic acid; lacta compounds, such as Azone; alkanols, such as oleylalcohol; and admixtures thereof. It is understood that a penetrationenhancer does not interfere with the chemical stability or pharmacologicaction of the active ingredient, or interact adversely with othercomponents(s) of the formulation. In certain embodiments, thepercutaneous carrier comprises between 40% and 99% w/w DMSO, useful as apenetration enhancer.

In some embodiments, the percutaneous carrier (or composition) furthercomprises a viscosity enhancing agent, also referred to as a gellingagent. A viscosity enhancing agent, as used herein, is a substance whichincreases the viscosity of a solution or liquid/solid mixture. Exemplaryviscosity enhancing agents include, but are not limited to, glycerin;cellulose derivatives (e.g., methylcellulose (MC);hydroxypropylmethylcellulose (HPMC); carboxymethylcellulose (CMC);microcrystalline cellulose (CC); ethyl cellulose; hydroxyethyl cellulose(HEC); hydroxypropyl cellulose (HPC); cellulose); gelatin; starch;hetastarch; poloxamers; pluronics; sodium CMC; sorbitol; acacia;povidone; carbopol; polycarbophil; chitosan; alginate; chitosanglutamate; hyaluronic acid; elastin; hyaluronan; maltodextrin DE;deoxyglycocholate (GDC); polymethacrylic acid; glycols (e.g.,polymethylene glycol; polyethylene glycol); cyclodextrins (e.g.,sulfobutylether B cyclodextrin); sodium tauro-dihydrofusidate (STDHF);and N-trimethyl chitosan chloride (TMC). In certain embodiments, theviscosity enhancing agent is a cellulose derivative, e.g., hydroxypropylcellulose (HPC). In certain embodiments, the composition comprises aviscosity enhancing agent in about 0.5% to about 5% by weight,inclusive, e.g., 0.5%, 0.6%, 0.7%, 0.8%, 0.9%, 1%, 2%, 3%, 4%, or 5% byweight. In certain embodiments, the composition comprises a viscosityenhancing agent in about 1% by weight.

In certain embodiment, the composition is a gel.

In certain embodiments, the composition further comprises anantioxidant, e.g., alpha tocopherol, ascorbic acid, acorbyl palmitate,butylated hydroxyanisole, butylated hydroxytoluene, monothioglycerol,potassium metabisulfite, propionic acid, propyl gallate, sodiumascorbate, sodium bisulfite, sodium metabisulfite, and sodium sulfite,in between about 0.001% to about 0.1% by weight, inclusive; e.g., about0.002%, about 0.004%, about 0.006%, about 0.008%, about 0.01%, about0.02%, about 0.04%, about 0.06%, about 0.08%, or about 0.1% by weight.In certain embodiments, the composition comprises an antioxidant inabout 0.002% by weight.

In certain embodiments, the composition is anhydrous, and containsbetween 0% and about 1% by weight of water, inclusive. However, incertain embodiments, the composition does comprise water; e.g., forexample, water is added to the composition and comprises greater than 1%of water. In certain embodiments, the composition comprises betweenabout 5% to about 30% by weight, inclusive, of water, e.g., betweenabout 10% to about 25% by weight of water, inclusive.

Although the descriptions of compositions provided herein areprincipally directed to compositions which are suitable foradministration to humans, it will be understood by the skilled artisanthat such compositions are generally suitable for administration toanimals of all sorts. Modification of compositions suitable foradministration to humans in order to render the compositions suitablefor administration to various animals is well understood, and theordinarily skilled veterinary pharmacologist can design and/or performsuch modification with ordinary experimentation. General considerationsin the formulation and/or manufacture of compositions can be found, forexample, in Remington: The Science and Practice of Pharmacy 21st ed.,Lippincott Williams & Wilkins, 2005.

Still further encompassed by the invention are pharmaceutical orcosmetic packs and/or kits. Pharmaceutical or cosmetic packs and/or kitsprovided may comprise a provided composition (i.e., a pharmaceutical orcosmetic composition) and a container (e.g., a vial, ampoule, bottle,syringe, and/or dispenser package, or other suitable container). In someembodiments, provided kits may optionally further include a secondcontainer comprising a suitable aqueous carrier for dilution orsuspension of the provided composition for preparation of administrationto a subject. In some embodiments, contents of provided formulationcontainer and solvent container combine to form at least one unit dosageform.

The active ingredient can be administered using any amount and any localroute of administration effective for treatment. The exact amountrequired will vary from subject to subject, depending on the species,age, and general condition of the subject, the severity of theinfection, the particular composition, its mode of administration, itsmode of activity, and the like.

The active ingredient is typically formulated in dosage unit form forease of administration and uniformity of dosage. It will be understood,however, that the total daily usage of the compositions of the presentinvention will be decided by the attending physician within the scope ofsound medical judgment. The specific therapeutically effective doselevel for any particular subject will depend upon a variety of factorsincluding the condition being treated and the severity of the condition;the activity of the specific active ingredient employed; the specificcomposition employed; the age, body weight, general health, sex and dietof the subject; the time of administration, route of administration, andrate of excretion of the specific active ingredient employed; theduration of the treatment; drugs used in combination or coincidentalwith the specific active ingredient employed; and like factors wellknown in the medical arts.

The desired dosage can be delivered three times a day, two times a day,once a day, every other day, every third day, every week, every twoweeks, every three weeks, or every four weeks. In certain embodiments,the desired dosage can be delivered using multiple administrations(e.g., two, three, four, five, six, seven, eight, nine, ten, eleven,twelve, thirteen, fourteen, or more administrations). As demonstrated inthe accompanying Examples, daily administration to the subject can beadequate (but not necessarily preferable) to achieve the desired effect.A daily administration schedule is considered convenient for human use.The active ingredient may be administered by the subject to himself orherself repeatedly and without special equipment or training, although amedical professional also can also administer the active ingredient tothe subject.

In certain embodiments, a therapeutically effective amount of the activeingredient for administration one or more times a day to may compriseabout 0.00001 mg to about 1000 mg per cm² of treated skin, about 0.0001mg to about 1000 mg per cm², about 0.001 mg to about 1000 mg per cm²,about 0.01 mg to about 1000 mg per cm², about 0.1 mg to about 1000 mgper cm², about 1 mg to about 1000 mg per cm², about 1 mg to about 100 mgper cm², about 1 mg to about 10 mg per cm², about 10 mg to about 1000 mgper cm², or about 100 mg to about 1000 mg per cm².

In certain percutaneous embodiments, the area of skin to be treated oneor more times a day to may comprise about 1 cm² to about 10,000 cm²,about 1 cm² to about 1,000 cm², about 1 cm² to about 100 cm², about 1cm² to about 10 cm², about 10 cm² to about 100 cm², about 10 cm² toabout 1,000 cm², about 100 cm² to about 1,000 cm², or about 1,000 cm² toabout 10,000 cm², inclusive.

In certain embodiments, a therapeutically effective amount of the activeingredient for administration one or more times a day to a 70 kg adulthuman may comprise about 0.0001 mg to about 3000 mg, about 0.0001 mg toabout 2000 mg, about 0.0001 mg to about 1000 mg, about 0.001 mg to about1000 mg, about 0.01 mg to about 1000 mg, about 0.1 mg to about 1000 mg,about 1 mg to about 1000 mg, about 1 mg to about 100 mg, about 10 mg toabout 1000 mg, or about 100 mg to about 1000 mg, inclusive, of theactive ingredient per unit dosage form. It will be appreciated that doseranges as described herein provide guidance for the administration ofprovided pharmaceutical compositions to an adult. The amount to beadministered to, for example, a child or an adolescent can be determinedby a medical practitioner or person skilled in the art and can be loweror the same as that administered to an adult.

In certain embodiments, the composition comprises between about 0.0001percent to about 5 percent by weight, inclusive, of a thiazolidinedioneor an orexigenic compound, or pharmaceutically acceptable salt orprodrug thereof, to the subject, e.g., between about 0.001 percent toabout 2 percent by weight, between about 0.01 percent to about 2 percentby weight, between about 0.1 percent to about 2 percent by weight,between about 0.5 and about 2 percent by weight, between about 1 percentto about 3 percent by weight, or between about 3 and about 5 percent byweight, inclusive.

In certain embodiments, the concentration of the thiazolidinedione isbetween about 0.001 percent to about 2 percent by weight, between about0.01 percent to about 2 percent by weight, between about 0.1 percent toabout 2 percent by weight, between about 0.5 and about 2 percent byweight, between about 1 percent to about 3 percent by weight, or betweenabout 3 and about 5 percent by weight, inclusive.

In certain embodiments, the concentration of the orexigenic pregnanederivative is between about 0.001 percent to about 2 percent by weight,between about 0.01 percent to about 2 percent by weight, between about0.1 percent to about 2 percent by weight, between about 0.5 and about 2percent by weight, between about 1 percent to about 3 percent by weight,or between about 3 and about 5 percent by weight, inclusive.

Various compositions are further contemplated herein.

For example, in one exemplary embodiment, the composition comprises athiazolidinedione or an orexigenic compound, or a pharmaceuticallyacceptable salt or prodrug thereof, and a percutaneous carriercomprising one or more fatty acids (e.g., oleic acid), wherein the fattyacid concentration is between about 1 and about 10 percent by weight,inclusive, in the composition. In certain embodiments, the percutaneouscarrier further comprises one or more organic alcohols (e.g., propyleneglycol and/or ethanol). In certain embodiments, the organic alcoholconcentration is between about 5 percent and about 99 percent,inclusive, by weight in the composition. In certain embodiments, thecomposition comprises the thiazolidinedione or the orexigenic compoundbetween about 0.1 percent and about 2 percent by weight, inclusive, inthe composition. In certain embodiments, the composition furthercomprises a penetration enhancer. In certain embodiments, thecomposition further comprises a viscosity enhancing agent. In certainembodiments, the composition further comprises an antioxidant.

For example, in one exemplary embodiment, the composition comprises athiazolidinedione or an orexigenic compound, or a pharmaceuticallyacceptable salt or prodrug thereof, and a percutaneous carriercomprising one or more organic alcohols (e.g., propylene glycol and/orethanol), wherein the organic alcohol concentration is between about 5percent and about 99 percent, inclusive, by weight in the composition.In certain embodiments, the composition further comprises one or morefatty acids (e.g., oleic acid), wherein the fatty acid concentration isbetween about 1 and about 10 percent by weight, inclusive, in thecomposition. In certain embodiments, the composition comprises thethiazolidinedione or the orexigenic compound between about 0.1 percentand about 2 percent by weight, inclusive, in the composition. In certainembodiments, the composition further comprises a penetration enhancer.In certain embodiments, the composition further comprises a viscosityenhancing agent. In certain embodiments, the composition furthercomprises an antioxidant.

In another exemplary embodiment, the composition comprises athiazolidinedione or an orexigenic compound, or a pharmaceuticallyacceptable salt or prodrug thereof, between about 0.1 percent and about2 percent by weight, inclusive, and a percutaneous carrier comprisingone or more fatty acids (e.g., oleic acid), propylene glycol andethanol, wherein the concentration of the fatty acid is between about 1and about 10 percent by weight, inclusive, the concentration of thepropylene glycol is between about 10 and about 40 percent by weight,inclusive, and the concentration of the ethanol is between about 50 andabout 90 percent by weight, inclusive, in the composition. In certainembodiments, the composition further comprises a viscosity enhancingagent at about 0.5 to about 2 percent by weight, inclusive. In certainembodiments, the composition further comprises an antioxidant.

In another exemplary embodiment, the composition comprises athiazolidinedione or an orexigenic compound, or a pharmaceuticallyacceptable salt or prodrug thereof, between about 0.1 percent and about1 percent by weight, inclusive, and a percutaneous carrier comprising afatty acid (e.g., oleic acid), propylene glycol, and ethanol, whereinthe concentration of the fatty acid is between about 1 to about 5percent by weight, inclusive, the concentration of the propylene glycolis between about 20 and about 40 percent by weight, inclusive, and theconcentration of the ethanol is between about 60 and about 80 percent byweight, inclusive, in the composition. In certain embodiments, thecomposition further comprises a viscosity enhancing agent at about 0.5to about 2 percent by weight, inclusive. In certain embodiments, thecomposition further comprises an antioxidant.

In yet another exemplary embodiment, the composition comprises athiazolidinedione or an orexigenic compound, or a pharmaceuticallyacceptable salt or prodrug thereof, between about 0.1 percent and about5 percent by weight, inclusive, and a percutaneous carrier comprisingoleic acid, propylene glycol, and ethanol, wherein the concentration ofthe oleic acid is about 3 percent by weight, inclusive, theconcentration of the propylene glycol is about 27 percent by weight,inclusive, and the concentration of the ethanol is about 65 to about 70percent by weight, inclusive. In certain embodiments, the compositionfurther comprises a viscosity enhancing agent at about 0.5 to about 2percent by weight, inclusive. In certain embodiments, the compositionfurther comprises an antioxidant.

In yet another exemplary embodiment, the composition comprises athiazolidinedione or an orexigenic compound, or a pharmaceuticallyacceptable salt or prodrug thereof, between about 0.1 percent and about5 percent by weight, inclusive, and a percutaneous carrier comprisingoleic acid, propylene glycol, and ethanol, wherein the concentration ofthe oleic acid is about 3 percent by weight, the concentration of thepropylene glycol is about 27 percent by weight, and the concentration ofthe ethanol is about 40 to about 60 percent by weight, inclusive. Incertain embodiments, the composition further comprises a viscosityenhancing agent at about 0.5 to about 2 percent by weight, inclusive. Incertain embodiments, the composition further comprises an antioxidant.

It will be also appreciated that the active ingredient can beadministered in combination with one or more additional therapeuticallyactive agents (“agents” or “active agents”). The compound or compositioncan be administered concurrently with, prior to, or subsequent to, oneor more additional agents. In general, the active ingredient and eachadditional active agent will be administered at a dose and/or on a timeschedule determined for the ingredient and agent. In will further beappreciated that the active ingredient and active agent utilized in thiscombination can be administered together in a single composition oradministered separately in different compositions. The particularcombination to employ in a regimen will take into account compatibilityof the active ingredient with the active agent and/or the desiredtherapeutic effect to be achieved. In general, it is expected thatadditional active agents utilized in combination be utilized at levelsthat do not exceed the levels at which they are utilized individually.In some embodiments, the levels utilized in combination will be lowerthan those utilized individually. The active ingredient can beadministered in combination with an active agent that improvesbioavailability, reduces and/or modifies metabolism, inhibits excretion,and/or modifies distribution within the body. It will also beappreciated that therapy employed may achieve a desired effect for thesame disorder, and/or it may achieve different effects.

EXAMPLES

In light of the foregoing description, the specific non-limitingexamples presented below are for illustrative purposes and not intendedto limit the scope of the invention in any way.

Example 1

A randomized controlled trial was conducted on C57BL/6J. Male miceapproximately six weeks old were prospectively randomized into groupsand assigned to the following treatment conditions (n=5 animals pergroup):

TABLE 1 Group Compound Class Formulation Dose 1 Vehicle Placebo Lipoderm0.1 cc to flank, daily 2 Pioglitazone Thiazolidinedione 5 mM in 0.1 ccto (PPARγ activator) Lipoderm flank, daily 3 Harmine β-carbolinealkaloid 5 mM in 0.1 cc to (PPARγ activator) Lipoderm flank, daily 4Megestrol Progesterone analog 5 mM in 0.1 cc to acetate Lipoderm flank,daily 5 Efavirenz Non-nucleoside 5 mM in 0.1 cc to reverse transcriptaseLipoderm flank, daily inhibitor

Animals were shaved and depilated over the flanks at the start of thestudy.

Animals were kept in identical conditions and fed ab libitum with astandardized high-fat diet (70% kcal fat). Animals were weighed threetimes weekly. Following 24 consecutive days of treatment, mice weresacrificed and samples of skin and adjacent fat from the treated flanksare taken for histologic examination.

Table 2 summarizes mean weight gain by group from Day 0 until Day 24.Compared to mice the vehicle group, those in Group 2 (pioglitazone) andGroup 4 (megestrol acetate) were associated with numerically higherweight gain.

TABLE 2 Mean Relative Group Compound Class weight gain to vehicle 1Vehicle Placebo 6.7 g 2 Pioglitazone Thiazolidinedione 7.4 g 112% (PPARγactivator) 3 Harmine β-carboline alkaloid 6.8 g 102% (PPARγ activator) 4Megestrol Progesterone analog 8.0 g 120% acetate 5 EfavirenzNon-nucleoside 6.1 g 92% reverse transcriptase inhibitor

Animals were examined on Day 24 with attention to relative skin foldthickness of the left and right flanks. Animals in Groups 1, 3, and 5appeared symmetric. Animals in Group 2 (pioglitazone) and Group 4(megestrol acetate) were asymmetric, with thicker skin folds on thetreated flanks compared to the untreated flanks. A representative viewof the asymmetry seen in Groups 2 and 4 is shown in FIG. 1. The skinfold on the right (treated) flank of the animal was markedly thicker(about 4 mm) than the skin fold on the left (untreated) flank (about 2mm). As shown in FIG. 2, the gross difference in skin fold thickness wasaccounted for by a difference in the thickness of subcutaneous fat, withthicker fat on the right (treated) flank versus the left (untreated)flank.

Example 2

A separate study was performed according to the methods in Example 1,wherein groups of animals were treated with vehicle, rosiglitazone 0.1%,or rosiglitazone 0.3% by weight. No adverse effects were noted. Skin andsubcutaneous tissue and muscle were collected at the end of the study,fixed in formalin, stained with hematoxylin and eosin, examinedmicroscopically, and measured digitally. Table 3 presents the absoluteand relative thicknesses of subcutaneous fat by treatment group, as wellas the relative increase in body mass. FIG. 3 show representativemicrographs of tissue from animals treated with vehicle androsiglitazone 0.3%. The micrographs showed a selective local increase inthe thickness of subcutaneous fat. No adverse effect, such asinflammation was seen.

TABLE 3 Mean Adipose Thickness Relative to Increase in body Compound(mm) ± SEM Vehicle (%) mass (%) Vehicle 0.295 ± 0.066 100%  6.6%Rosiglitazone 0.1% 0.472 ± 0.058 160%* 5.8% Rosiglitazone 0.3% 0.562 ±0.089 190%* 8.9%

Thus, in a prospective randomized trial in mice, percutaneousrosiglitazone was well tolerated caused a dose-dependent, local increasein subcutaneous fat without a systemic effect.

Example 3

A composition for locally increasing subcutaneous fat was prepared asfollows:

TABLE 4 Ingredients per 100 g of final product Amount ThiazolidinedioneRosiglitazone  1 g Antioxidant alpha-Tocopherol 0.002 g   Percutaneouscarrier Ethanol, anhydrous 69 g Propylene glycol 27 g Oleic acid  3 gViscosity enhancing agent Hdroxypropylcellulose  1 g (e.g., Klucel ®Grade HF)

Rosiglitazone was dissolved in ethanol. Propylene glycol and oleic acidwere added, and the resulting preparation was thoroughly mixed.Hydroxypropylcellulose was added and thoroughly mixed to yield about 100grams of gel with a final rosiglitazone concentration of about 1% (w/w).

Example 4

A prospective controlled trial was performed in 4 Gottingen minipigs (2males, 2 females). Hair on the back was clipped. A square-shapedRosiglitazone Treatment Area (50 cm²) was marked on the right side ofeach animal. An equivalent Vehicle Treatment Area was marked on the leftside of the animal, such that the two treatment areas were anatomicallyequivalent. Each Rosiglitazone Treatment Area was treated once dailywith 0.3 mL of the composition of Example 3; each Vehicle Treatment Areawas treated once daily with 0.3 mL of a corresponding vehicle (norosiglitazone). Animals were fed a standard diet, and observed for skincondition and overall health. After 42 days of treatment, plasmapharmacokinetics (PK) was assessed on all animals by LiquidChromatography/Tandem Mass Spectrometry. Necropsy was done and samplesof skin, subcutaneous fat, and muscle were collected en bloc from eachtreatment area in a controlled fashion. Samples were fixed in formalin,stained with hematoxylin and eosin, examined microscopically, andmeasured digitally at 6 systematically controlled locations pertreatment area (each location precisely contralateral to its counterparton the opposite treatment area). The treatment was well tolerated, withno evidence of skin irritation or other clinical observations. FIG. 5shows representative histologic results (skin at top of each slide;vertical line indicates distance from deep surface of dermis topanniculus carnosus, which is a muscle landmark). Increased thickness ofthe subcutaneous fat is apparent on treated tissue (T) compared to therespective control (C). Table 5 presents the thicknesses of subcutaneousfat on each of six treated and control (vehicle) locations, by animal.Treatment with percutaneous rosiglitazone was associated with astatistically significant, 48% local increase in subcutaneous fatthickness (p<0.0001). Table 6 compares plasma PK following percutaneousadministration (present study) with plasma PK following oraladministration in humans. Peak plasma concentrations and exposurefollowing percutaneous administration were negligible, i.e., about 3400-and 1300-fold lower than for oral (systemic) therapy. Thus, in a largemammal with skin similar to that of a human, daily administration ofrosiglitazone in a working percutaneous formulation caused localincreases in subcutaneous fat without any apparent systemic effect.Furthermore, systemic drug levels were pharmacologically negligible.

TABLE 5 Fat Thickness (mm) Rosiglizazone Location Animal RosiglitazoneVehicle Increase over Placebo A 1 7.87 6.13 28% A 2 5.09 2.55 100% A 37.30 5.10 43% A 4 5.72 5.28 8% B 1 7.82 4.58 71% B 2 7.47 3.57 110% B 36.47 5.26 23% B 4 5.86 4.25 38% C 1 9.84 5.65 74% C 2 6.47 3.16 104% C 38.62 5.66 52% C 4 3.95 5.16 −23% D 1 7.24 6.33 14% D 2 5.20 3.62 44% D 37.68 3.97 94% D 4 3.73 4.07 −8% E 1 5.59 4.54 23% E 2 3.70 1.86 99% E 38.46 4.82 76% E 4 4.21 4.66 −10% F 1 6.39 4.40 45% F 2 3.07 1.85 66% F 38.30 5.21 59% F 4 4.88 3.72 31% MEAN 6.29* 4.39 48% p < .0001 (pairedt-test)

TABLE 6 Parameter Percutaneous Oral** Percutaneous:Oral Ratio AbsoluteDose 3 4 0.75 mg/d Peak plasma level 0.1* 355 ~3400 (C_(max)) ng/mLPlasma exposure 1.9* 2542 ~1300 (AUC₀₋₂₄) ng * h/mL AUC₀₋₂₄ = Area Underthe Curve, 0-24 hours *Human equivalent (mean pig weight 14 kg, humanscaling factor = 5) **Chen et al., Simultaneous determination andpharmacokinetic study of metformin and rosiglitazone in human plasma byHPLC-ESI-MS, J Chromatog Sci (2011) 49: 94-100. Dose is typical dose foradults with diabetes.

Example 5

To identify potential percutaneous formulations, skin permeation studieswere conducted with various formulations of rosiglitazone, ex vivo, onfresh minipig skin. Harvested skin was mounted on a standard(Franz-type) diffusion cell apparatus. All test articles contained 0.1%(weight/weight) of rosiglitazone. Each test article (8 mg) was uniformlyapplied to a skin surface of 0.8 cm². Treated skin was left open to theatmosphere to simulate clinical conditions. Receptor fluid flowedcontinuously over 24 hours and was collected in fractions. The amount ofrosiglitazone in these fractions was determined by LiquidChromatography/Tandem Mass Spectrometry. The following amounts of drugwere recovered from receptor fluid over 24 hours:

TABLE 7 Formulation Drug mass (ng, mean) Lipoderm ® 0 1,3-butanediol 0Ethanol 70%, PG 30% 770 Ethanol 70%, PG 27%, oleic acid 3% 3129 Ethanol75%, LL 25% 2367 LL = lauryl lactate, PG = propylene glycol

Thus, in a study in ex vivo skin, a formulation of rosiglitazonecomprising oleic acid provided superior drug penetration compared to arange of other formulations and known enhancers, including Lipoderm®,butanediol, and lauryl lactate.

Example 6

The following experiment describes a randomized, double-blind study inhuman subjects to test if a percutaneously administeredthiazolidinedione increases fat in the cheeks of HIV-seropositivepatients on antiretroviral therapy who are suffering from HIVlipodystrophy.

Eligible subjects (for example, n=40) with HIV lipodystrophy andcharacteristic facial fat atrophy are entered into a randomizeddouble-blind study. Subjects are randomized in 1:1 fashion to receiveeither rosiglitazone (for example, 1% in a percutaneous vehicle), orvehicle alone. The vehicle is, for example, according to Example 3.Products are unlabeled as to the presence of rosiglitazone or vehicle.Subjects are instructed to apply, once a day, the contents of onesyringe to the cheeks.

Serial clinical exams and non-invasive imaging are conducted at thebeginning of the study and then at monthly intervals. Based on clinicalexams, the degree of fat atrophy is rated on a scale of 1 to 5.Treatment continues for 3 months.

It is contemplated that after a period of time, for example after 3months of treatment, pioglitazone will be associated with a subjectiveand/or objective increase in cheek fat, whereas vehicle will not. Serialnoninvasive imaging (for example, ultrasound or computed tomography)will confirm an increase in cheek fat due to an increase in subcutaneousfat thickness.

Example 7

The following description exemplifies a clinical application ofpercutaneous administration of a thiazolidinedione for midfaceaugmentation.

A female or male patient wishes to undergo a midface augmentationprocedure but is concerned about the risks of surgery. The physicianprescribes a daily application of rosiglitazone (for example, as thecomposition of Example 3) to the skin of both breasts.

It is contemplated that after a period of time, for example after 3months of treatment, the breasts appear clinically larger. Serialnoninvasive imaging (for example, ultrasound or computed tomography)will confirm an increase in breast size due to an increase insubcutaneous fat thickness.

Example 8

The following description exemplifies a clinical application ofpercutaneous administration of a thiazolidinedione for breastaugmentation.

A female or male patient wishes to undergo a breast augmentationprocedure but is concerned about the risks of surgery. The physicianprescribes a daily application of rosiglitazone (for example, as thecomposition of Example 3) to the skin of both breasts.

It is contemplated that after a period of time, for example after 3months of treatment, the breasts appear clinically larger. Serialnoninvasive imaging (for example, ultrasound or computed tomography)will confirm an increase in breast size due to an increase insubcutaneous fat thickness.

Example 9

The following description exemplifies a clinical application ofpercutaneous administration of an orexigenic pregnane derivative foraugmentation of the buttocks.

A female or male patient wishes to undergo a buttocks augmentationprocedure but is concerned about the risks of surgery. The physicianprescribes a daily application of megestrol acetate (for example, 10mg/ml in Lipoderm®) to the buttocks.

It is contemplated that after a period of time, for example after 6months of treatment, the buttocks appear clinically larger. Serialnoninvasive imaging (for example, ultrasound or computed tomography)will confirm an increase in buttocks size due to an increase insubcutaneous fat thickness.

Example 10

The following description exemplifies application of the invention toreduce skin wrinkles.

A female or male patient is bothered by wrinkles on the skin of thehands. The physician prescribes a daily application of rosiglitazone(for example, as the composition of Example 3) to the dorsal skin ofboth hands.

It is contemplated that after a period of time, for example after 3months of treatment, the skin wrinkles appear lessened on clinical exam.Serial noninvasive imaging (for example, ultrasound) will confirm anincrease in subcutaneous fat thickness on the dorsum of the hands.

Example 11

A study is conducted according to the protocol of Example 4.Concentrations of rosiglitazone are determined in plasma and in fat fromthe Rosiglitazone Treatment Area and Vehicle Treatment Area (each on aweight per weight basis). It is predicted that rosiglitazoneconcentrations will be substantially higher in fat from theRosiglitazone Treatment Area compared to fat from the Vehicle TreatmentArea or compared to plasma. For example, it is predicted thatrosiglitazone concentrations in fat from the Rosiglitazone TreatmentArea will be at least 100-fold, or at least 1000-fold higher than in fatfrom the Vehicle Treatment Area. Also for example, it is predicted thatrosiglitazone concentrations in fat from the Rosiglitazone TreatmentArea will be at least 100-fold or at least 1000-fold higher than inplasma.

Other Embodiments

In the claims articles such as “a,” “an,” and “the” may mean one or morethan one unless indicated to the contrary or otherwise evident from thecontext. Claims or descriptions that include “or” between one or moremembers of a group are considered satisfied if one, more than one, orall of the group members are present in, employed in, or otherwiserelevant to a given product or process unless indicated to the contraryor otherwise evident from the context. The invention includesembodiments in which exactly one member of the group is present in,employed in, or otherwise relevant to a given product or process. Theinvention includes embodiments in which more than one, or all of thegroup members are present in, employed in, or otherwise relevant to agiven product or process.

Furthermore, the invention encompasses all variations, combinations, andpermutations in which one or more limitations, elements, clauses, anddescriptive terms from one or more of the listed claims is introducedinto another claim. For example, any claim that is dependent on anotherclaim can be modified to include one or more limitations found in anyother claim that is dependent on the same base claim. Where elements arepresented as lists, e.g., in Markush group format, each subgroup of theelements is also disclosed, and any element(s) can be removed from thegroup. It should it be understood that, in general, where the invention,or aspects of the invention, is/are referred to as comprising particularelements and/or features, certain embodiments of the invention oraspects of the invention consist, or consist essentially of, suchelements and/or features. For purposes of simplicity, those embodimentshave not been specifically set forth in haec verba herein. It is alsonoted that the terms “comprising” and “containing” are intended to beopen and permits the inclusion of additional elements or steps. Whereranges are given, endpoints are included. Furthermore, unless otherwiseindicated or otherwise evident from the context and understanding of oneof ordinary skill in the art, values that are expressed as ranges canassume any specific value or sub-range within the stated ranges indifferent embodiments of the invention, to the tenth of the unit of thelower limit of the range, unless the context clearly dictates otherwise.

This application refers to various issued patents, published patentapplications, journal articles, and other publications, all of which areincorporated herein by reference. If there is a conflict between any ofthe incorporated references and the instant specification, thespecification shall control. In addition, any particular embodiment ofthe present invention that falls within the prior art may be explicitlyexcluded from any one or more of the claims. Because such embodimentsare deemed to be known to one of ordinary skill in the art, they may beexcluded even if the exclusion is not set forth explicitly herein. Anyparticular embodiment of the invention can be excluded from any claim,for any reason, whether or not related to the existence of prior art.

Those skilled in the art will recognize or be able to ascertain using nomore than routine experimentation many equivalents to the specificembodiments described herein. The scope of the present embodimentsdescribed herein is not intended to be limited to the above Description,but rather is as set forth in the appended claims. Those of ordinaryskill in the art will appreciate that various changes and modificationsto this description may be made without departing from the spirit orscope of the present invention, as defined in the following claims.

What is claimed is:
 1. A method for increasing subcutaneous fat locallyin a body of a subject in need thereof, the method comprising topicallyadministering to the skin of the subject a thiazolidinedione selectedfrom the group consisting of:

and pharmaceutically acceptable salts thereof, using a percutaneouscarrier selected from the group consisting of ethanol, propylene glycol,oleic acid, and lauryl lactate, in order to deliver an effective amountof the thiazolidinedione to the subcutaneous fat of the subject.
 2. Themethod of claim 1, wherein the subject suffers from a subcutaneous fatdeficiency.
 3. The method of claim 2, wherein the subcutaneous fatdeficiency is associated with a metabolic disorder.
 4. The method ofclaim 2, wherein the subcutaneous fat deficiency is acquired.
 5. Themethod of claim 4, wherein the acquired subcutaneous fat deficiency isHIV-associated lipodystrophy, lipidema, acquired partial lipodystrophy,acquired generalized lipodystrophy, Parry-Romberg syndrome, juveniledermatomyositis, centrifugal abdominal lipodystrophy, lipoatrophiaannularis, or localized lipodystrophy.
 6. The method of claim 2, whereinthe subcutaneous fat deficiency is caused by a medication, surgery, oran injury.
 7. The method of claim 1, wherein the subject suffers fromwrinkles of the skin.
 8. The method of claim 1, wherein the subjectsuffers from dissatisfaction with the size or contour of a body part. 9.The method of claim 8, wherein the body part is the face, forehead,periorbital region of the face, cheeks, chin, lips, breast, limbs,hands, trunk, hips, or buttocks.
 10. The method of claim 1, wherein thesubject has transplanted fat.
 11. The method of claim 1, wherein thethiazolidinedione is rosiglitazone or a pharmaceutically acceptable saltthereof.
 12. The method of claim 11, wherein the rosiglitazone isadministered in a composition at a concentration between about 0.1percent and about 2 percent by weight.
 13. The method of claim 1,wherein the percutaneous carrier comprises oleic acid.
 14. The method ofclaim 13, wherein the oleic acid is administered in a composition at aconcentration between about 1 percent and about 5 percent by weight. 15.The method of claim 1, wherein the percutaneous carrier comprisespropylene glycol.
 16. The method of claim 15, wherein the propyleneglycol is administered in a composition at a concentration between about20 percent and about 40 percent by weight.
 17. The method of claim 1,wherein the percutaneous carrier comprises propylene glycol and oleicacid.
 18. The method of claim 1, wherein the fat is locally increased byat least 10 percent, at least 20 percent, at least 30 percent, or atleast 40 percent compared to control.
 19. The method of claim 1, whereinincreasing fat locally occurs locally on the face, breast, limbs, hands,trunk, hips, or buttocks.
 20. The method of claim 1, wherein theadministering is three times a day, twice a day, once a day, every otherday, or every third day.